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TWENTY-FIVE  YEARS 


—WITH — 


THE   INSANE 


BY  DANIEL  PUTNAM, 

LATE  CHAPLAIN  OP  MICHIGAN  ASYLUM,  AT  KALAMAZOO. 


DETROIT : 
JOHN    MACFAKLANE. 

1885. 


COPYRIGHT  BY 

DANIEL  PUTNAM, 

1885. 


WINN  &   HAMMOND, 

PRINTERS  AND  BINDERS, 

DETROIT,  MICH. 


PREFATORY  NOTE. 


The  author  desires,  in  this  way,  to  acknowledge 
his  obligations  to  the  Superintendents  of  the  asy- 
lums for  the  insane  in  Michigan,  and  especially 
to  Dr.  PALMER,  of  Kalamazoo,  for  his  kindness  in 
examining  the  manuscript  of  the  book,  and  for 
many  valuable  suggestions.  It  should  be  stated, 
however,  that  he  is  in  no  degree  responsible  for 
any  opinions  and  ideas  expressed. 

It  is  deemed  necessary  to  make  only  this  gen- 
eral acknowledgment  for  the  material  derived 
from  historical  and  other  books  treating  of  men- 
tal diseases,  since  those  works  are  well  known  to 
all  familiar  with  the  literature  of  insanity,  and 
most  of  the  matter  thus  obtained  is,  to  a  large 
extent,  common  property. 

The  author  is  under  much  obligation  to  H.  A. 
FOED,  Esq.,  for  his  invaluable  assistance  in  the 
corrections  of  proofs,  and  for  many  typograph- 
ical suggestions. 

Messrs.  Wiisrisr  &  HAMMOND  also  deserve  grate- 
ful mention  for  the  beautiful  form  in  which  the 
book  appears. 


CONTENTS. 


CHAPTER.  PAGE. 

I.  INTRODUCTORY  AND  PERSONAL 1 

II.  INSANITY  AND  ITS   TREATMENT  AMONG  THE  AN- 
CIENTS      12 

III.  THE  INSANE  DURING  THE  EARLY  CHRISTIAN  CEN- 

TURIES      16 

IV.  THE  FIRST  HOSPITALS  AND  ASYLUMS  FOR  THE  IN- 

SANE AND  THEIR  CHARACTER 23 

V.   CURIOUS  SUPERSTITIONS,  AND  STRANGE   METHODS 

OF  TREATING  THE  INSANE 80 

VI.   THE  BEGINNINGS  OF  REFORM  AND  IMPROVEMENT..     38 
VII.   THE  MODERN  ASYLUM 47 

VIII.   GUARANTIES  FOR  THE   SAFETY  AND  PROPER  CARE 

OF  THE  INSANE  IN  ASYLUMS 54 

IX.  TREATMENT  OF  THE  INSANE  OUTSIDE  OF  ASYLUMS.  .     70 

X.  OPINIONS  AND  FEELINGS  OF  PATIENTS 76 

XI.  SCHOOLS  AND  INSANITY ' 86 

XII.  RELIGION  AND  INSANITY 94 

XIII.  ALCOHOL  AND  INSANITY 104 

XIV.  TOBACCO  AND  OTHER  NARCOTICS  AND  INSANITY.  . .  109 
XV.  INHERITED  TENDENCIES  AND  INSANITY • 116 

XVI.  INSANITY  AND  CRIME 128 

XVII.   CONCLUDING  THOUGHTS  .  ,  141 


TWENTY-FIVE  YEARS  WITH  THE  INSANE. 


CHAPTER  I. 
INTRODUCTOEY  AND  PERSONAL. 

The  Michigan  Asylum  for  the  Insane,  at  Kalama- 
zoo,  was  opened  in  August,  1859.  A  little  later  in 
that  year  I  was  invited  by  the  Medical  Superintend- 
ent, Dr.  Yan  Deusen,  to  conduct  the  first  religious 
service  held  in  the  institution.  This  was  the  begin- 
ning of  a  connection  with  the  asylum  which  con- 
tinued for  five-and-twenty  years.  Consequently,  dur- 
ing a  large  part  of  an  ordinary  lifetime  I  have  been 
brought  into  somewhat  intimate  relation  with  the 
insane,  and  with  the  officers  of  an  institution  which 
may  justly  claim  to  rank  among  the  very  best  in  the 
country.  These  many  years  have  given  abundant 
opportunities  for  observing  many  varieties  of  mental 
disease,  and  for  learning  whatever  an  unprofessional 
observer  might  be  able  to  learn.  .One  would  be 
indeed  beyond  hope  of  forgiveness  if  nothing  of 
value  to  himself  and  others  were  gathered  up  with 


2  TWENTY-FIVE   YEARS 

such  facilities.  I  have  a  desire,  if  possible,  to  render 
this  knowledge  of  some  practical  service  to  parents, 
teachers,  students,  and  others  employed  in  the  com- 
mon pursuits  and  business  of  every-day  life.  It  is 
for  this  reason,  chiefly,  that  I  write  these  chapters. 

I  wish,  at  the  outset,  to  guard  against  a  possible 
misconception  of  the  nature  and  character  of  the 
book.  It  is  not  necessary  to  say  that  I  do  not  write 
as  a  physician  or  a  specialist,  because  that  would  be 
readily  understood.  It  might,  however,  on  account 
of  the  position  which  I  have  occupied,  not  unnatur- 
ally be  supposed  that  I  have  studied  and  observed  as 
a  clergyman,  and  that  I  speak  as  a  member  of  that 
honored  profession.  I  count  it,  on  the  whole,  a 
fortunate  thing  that  I  am  only  a  layman,  authorized 
by  the  custom  of  the  religious  organization  with 
which  I  am  connected  to  conduct  the  exercises  of 
social  and  public  worship.  My  diities  as  a  teacher 
have  brought  me  constantly,  for  more  than  thirty 
years,  into  daily  contact  with  young,  healthy,  and 
vigorous  mental  and  physical  life.  The  means  have, 
therefore,  been  at  hand  for  comparing,  at  pleasure  and 
day  by  day,  normal  and  morbid  mental  activity.  If 
one  had  desired,  it  would  have  been  impossible  to  avoid 
such  comparison,  or  to  forbear  drawing  from  it  lessons 
for  the  school-room  and  the  home.  I  write,  conse- 
quently, especially  as  a  teacher,  and  as  a  student,  in  a 
very  humble  way,  of  the  science  of  mind,  in  which  pro- 
fessional duties  have  required  me  to  give  instruction. 


WITH    THE    INSANE.  3 

I  do  not  speak  upon  the  subject  of  insanity  as  an 
expert.  I  wish  distinctly  and  emphatically  to  disclaim 
any  such  purpose.  I  have  neither  the  knowledge  nor 
the  inclination  necessary  to  enable  me  to  do  a  work 
of  that  kind.  Besides,  perfect  candor  impels  the  con- 
fession that  observation,  both  within  and  without  the 
asylum,  leads  me  to  estimate  at  a  very  moderate 
value  the  opinions  of  the  majority  of  self-constituted 
experts.  I  can  not  resist  the  conviction  that  so-called 
expert  testimony  has  been  the  occasion,  if  not  the 
cause,  of  much  harm  to  the  worthy  and  honest 
insane,  both  in  the  courts  and  elsewhere. 

Having  thus  guarded  against  misapprehension  in 
one  direction,  it  may  be  allowable  to  say  a  word  in 
rejation  to  the  position  and  duties  of  a  chaplain  in  an 
asylum  for  the  insane,  as  they  appear  in  the  light  of 
experience  and  reflection.  The  impression  is  doubt- 
less general,  that  the  chaplain  of  an  institution  of  any 
kind  is  an  officer  charged  with  duties  mainly,  if  not 
exclusively,  religious  in  their  character.  It  is  sup- 
posed, not  unnaturally,  that  he  has  to  do  almost 
exclusively  with  the  moral  and  spiritual  condition 
of  the  inmates,  and  that  in  this  sphere  he  should 
have  the  right  to  act  with  entire  freedom  from  the 
control  or  direction  of  any  superior.  Any  inter- 
ference, by  dictation  or  by  very  earnest  suggestion, 
with  his  purposes,  plans,  or  methods  of  labor,  would 
be  considered  by  some  persons  as  an  infringement 


4  TWENTY-FIVE   YEARS 

upon  prerogative,  if  not  upon  the  province  of  con- 
science itself. 

This  view  of  the  position  and  rights  of  a  chaplain 
may  be  correct,  for  aught  I  know,  in  institutions 
where  inmates  are  free  from  any  irregular  activity, 
either  of  the  intellect  or  the  emotions. 

But  experience  and  observation  have  gradually 
brought  me  to  the  conviction  that  this  officer  can  not 
occupy  such  a  position  of  independence  and  self- 
direction  in  an  asylum  for  the  insane  with  safety  to 
the  general  interests  of  the  institution,  or  with  advan- 
tage to  the  inmates  themselves,  unless  he  possesses 
unusual  soundness  of  judgment,  great  prudence  and 
discretion,  and  much  practical  knowledge  of  insanity 
and  the  insane.  This  conclusion  has  not  been  reached 
hastily,  nor  as  a  result  of  any  expressions  of  opinion 
on  the  part  of  the  medical  superintendents  or  other 
officers  with  whom  I  have  been  associated.  During 
five-and-twenty  years  I  received  no  dictation,  no  un- 
pleasant or  undesired  suggestions,  and  no  restraint  of 
any  kind  upon  liberty  of  speech  or  action.  Yet  I  am 
sure  my  mistakes  would  have  been  much  more  fre- 
quent and  serious,  in  personal  intercourse  with 
patients,  but  for  wise  and  timely  counsel  given  in 
the  most  delicate  and  oftentimes  indirect  manner. 

In  his  general  duties  the  chaplain  is  not  a  pastor  in 
the  common  acceptation  of  that  term.  The  ordinary 
methods  of  a  pastor,  transferred  to  the  halls  of  an 
asylum,  might  easily  work  untold  evil.  In  the 


WITH  THE   INSANE.  5 

public  services  of  the  chapel  the  differences  are 
much  less.  The  general  truths  of  the  gospel  may  be 
spoken  with  ordinary  freedom  and  plainness.  It  will 
only  be  necessary  to  avoid  exciting  topics  and  excit- 
ing manners  and  methods.  It  hardly  needs  to  be  sug- 
gested that  the  distinctive  doctrines  and  peculiarities 
of  sects  and  parties  would  be  sadly  out  of  place  in 
ministering  to  such  an  audience. 

It  is  in  the  direct  personal  intercourse  of  the  chap- 
lain with  patients  that  he  finds  the  need  of  peculiar 
wisdom  and  discretion.  In  this  intercourse,  with  the 
best  of  intentions,  it  will  be  easy  to  inflict  much 
injury,  and  to  hinder  the  progress  of  recovery.  To  a 
large  extent,  religious  truth  and  religious  instruction 
and  exhortation  appeal  to  the  emotional  nature. 
In  many,  perhaps  in  a  majority  of  cases,  especially 
among  females,  mental  disease  touches  directly  or  in- 
directly this  part  of  the  nature.  It  will  not  be  diffi- 
cult, in  cases  of  this  sort,  to  excite  a  morbid  and 
harmful  degree  of  emotional  activity.  This  intensity 
of  feeling,  of  whatever  nature  it  may  be,  produces 
unfavorable  results  upon  the  nervous  system, 
prevents  rest,  and  tends  to  create  irritability  and 
even  maniacal  excitement.  This  illustration  will  be 
sufficient  to  indicate  some  of  the  difficulties  to.  be  met, 
and  the  necessity  of  receiving  advice  and  counsel 
from  the  medical  officers  who  have  carefully  studied 
the  peculiar  conditions  of  individual  inmates.  Relig- 
ious services  and  religious  reading  or  conversation  are, 


6  TWENTY-FIVE  YEAES 

at  some  times  and  in  some  circumstances,  the  occa- 
sion, if  not  the  cause,  of  much  suffering  and  evil  to 
individuals.  And  not  unfrequently  such  persons 
have  a  very  strong  desire  for  such  reading  and 
conversation.  The  chaplain  will  very  likely  be 
reproached  for  apparently  neglecting  these  patients, 
and  the  officers  in  charge  will  be  accused  of  cruelty 
for  refusing  permission  to  attend  church  or  chapel 
exercises. 

The  inquiry  has  frequently  been  made  of  me  by 
those  not  familiar  with  the  interior  life  of  an  asylum 
for  the  insane,  whether  the  services  of  a  chaplain  can 
be  of  any  real  value  to  the  inmates  of  such  an  insti- 
tution. My  present  position  will  enable  me  to  ex- 
press an  opinion  upon  this  question  free  from  the 
supposed  influence  of  personal  interest. 

The  inquiry  comes,  in  most  cases,  from  persons 
who  do  not  know,  or  fail  to  keep  in  mind,  the  widely 
differing  classes  of  inmates  and  the  numerous  varieties 
of  mental  disease.  Patients  suffering  from  complete 
dementia,  or  from  violent  attacks  of  acute  mania,  are, 
for  the  time,  beyond  the  reach  of  instruction  or  of  hu- 
man consolation  by  any  direct  communication  of  mind 
with  mind  by  ordinary  religious  services.  But 
among  almost  all  other  classes  of  inmates  there  are 
very  many  individuals  who  receive,  directly  or 
indirectly,  I  believe,  great  benefit  from  personal  con- 
versation and  from  the  chapel  services.  Not  a  few 
of  these  are  members  of  churches.  They  have  been 


WITH   THE   INSANE.  7 

accustomed  to  attend  public  and  social  worship. 
Such  periods  of  devotion  and  instruction  have  become 
an  important  part  of  their  conception  of  life  and 
duty.  When  these  can  not  be  enjoyed,  the  loss  is 
deeply  and  sorely  felt,  though  it  may  not  be  very 
clearly  understood  or  expressed.  The  condition  is 
like  that  of  which  most  of  us  have  been  conscious,  at 
one  time  or  another:  something  is  wanting, — we  may 
not  be  able  to  tell  what, — but  there  is  a  feeling  of 
vague  and  distressing  unrest  which  prevents  all  con- 
tentment and  repose  of  mind.  This  unrest  is  a 
great  obstacle  to  recovery,  especially  when  the  power 
of  self-control  has  been  lost  or  seriously  weakened. 

Moreover,  many  patients  suffer  from  mild  or  peri- 
odic forms  of  mental  disorder.  Excepting  at  inter- 
vals of  greater  or  less  frequency,  they  are  in  posses- 
sion of  a  good  degree  of  intellectual  strength.  In 
addition  to  these,  there  are  always  persons  nearly  or 
quite  restored  to  their  usual  degree  of  health,  waiting 
for  time  to  give  confirmed  vigor  both  of  body  and 
mind. 

To  both  these  classes  all  truths  have  a  familiar 
and  accustomed  sound.  The  forms  of  worship,  the 
tones  of  prayer,  the  songs  of  praise,  words  of  instruc- 
tion and  exhortation  and  comfort,  are  to  them  the 
same  here  as  elsewhere.  By  such  well-known  and 
often  highly  prized  services,  assurance  is  constantly 
given  that  they  are  not  cast  out  from  friendly  and 
Christian  society  and  from  personal  and  Christian 


8  TWENTY-FIVE  YEAKS 

sympathy,  although  sundered  from  home  and  the 
ordinary  relationships  and  associations  of  life.  In 
some  cases  this  is  a  potent  factor  in  stimulating  effort 
to  recover  self-control,  and  in  keeping  the  soul 
from  sinking  into  apathy,  if  not  into  despair.  In  this 
and  in  other  ways,  the  chaplaincy,  entirely  apart  from 
any  considerations  of  a  moral  and  religious  character, 
takes  an  important  place  among  the  so-called  moral 
means  of  curing  or  alleviating  insanity.  It  is  quite 
possible  that  its  highest  value  is  found  here.  I  am 
persuaded  also  that  its  good  influence  often  reaches 
even  to  the  disturbed  and  demented  patients.  The 
sympathizing  and  comforting  utterances  of  the  "  Man 
of  Sorrows,"  falling  upon  ears  accustomed  elsewhere 
and  under  happier  circumstances  to  listen  to  them, 
are  like  sweet  strains  of  music  heard  long  ago  and 
dimly  and  faintly  remembered.  They  convey  little 
conscious  instruction  or  consolation,  and  may  hardly 
be  retained  until  the  brief  service  is  ended.  But 
even  thus  they  are  not  altogether  worthless.  The 
attention  has  been  caught  and  held  for  a  moment ; 
the  memory  has  been  half  awakened,  and  has  groped 
for  an  instant  amid  the  mental  darkness  after  the 
forgotten.  Over  the  vacant  face  and  into  the  dull 
eyes,  has  flashed  a  single  gleam  of  returning  intelli- 
gence. Down  into  the  brooding  gloom  has  fallen 
one  ray  of  blessed  light,  and,  for  a  brief  interval,  the 
marvelous  grasp  of  some  strange,  strong  delusion  has 
been  loosened.  A  little  gleam  of  coming  hope  has 


WITH  THE   INSANE.  9 

faintly  illumined  the  darkness  of  the  present.  There 
has  been  a  little  ray  of  blessed  sunlight  through 
the  clouds.  An  existence  which,  to  an  observer, 
seems  only  a  grievous  burden,  has  been  made  tolera- 
ble, at  least  for  a  passing  moment. 

These  introductory  and  personal  considerations 
may  find  a  fitting  close  in  some  statements  concern- 
ing the  number  of  patients  who  have  been  under 
treatment  since  my  connection  with  the  asylum 
began.  At  the  time  of  the  first  religious  service, 
only  a  small  portion  of  one  wing  of  the  original 
building  had  been  completed,  and  only  females 
had  been  admitted.  The  number  of  patients 
was  but  thirty-one,  and  the  whole  popula- 
tion connected  with  the  place  was  scarcely  fifty 
persons.  On  the  first  of  October  of  this  year  (1884), 
the  number  of  patients  was  seven  hundred  and  nine- 
ty-eight, and  the  whole  resident  population  more 
than  nine  hundred.  During  these  twenty-five  years 
3859  patients  have  been  received.  Of  this  large 
number,  nine  hundred  and  thirty-six  have  been  dis- 
charged as  restored  to  usual  health,  and  seven 
hundred  and  seventy  as  more  or  less  improved. 

The  Eastern  Asylum  at  Pontiac  has  been  opened  for 
six  years  and  two  months.  On  the  first  of  October, 
1884,  it  had  six  hundred  and  fifty-three  patients. 
Since  its  opening  it  has  admitted  1474,  and  dis- 
charged as  cured  two  hundred  and  fifty-six,  and  as 
improved  two  hundred  and  seventy-eight. 


10  TWENTY-FIVE  YEARS 

Up  to  October  1,  1884,  both  asylums  have  admitted 
5333  patients,  and  have  discharged  as  restored  1182, 
and  as  improved  1048. 

These  figures  have,  in  one  direction,  an  aspect  of 
peculiar  and  inexpressible  sadness.  They  stand,  in 
many  cases,  for  homes  darkened  and  the  most  tender 
ties  rudely  broken.  Though  silent,  they  speak  of  a 
vast  amount  of  human  suffering  and  sorrow,  and  of 
suffering  and  sorrow  in  forms  which  have  hitherto 
received  less  than  a  just  share  of  pity  and  sympathy 
and  consideration. 

In  another  aspect  they  afford  a  little  light  amid  the 
general  gloom,  a  little  sunshine  in  spite  of  the  clouds. 
The  shadows  remain,  but  they  are  much  relieved. 
Many  who  came  to  the  asylum  sick  in  mind  and 
body,  have  departed  "clothed  and  in  their  right 
minds."  Hundreds  of  homes,  scattered  over  the 
State,  have  been  made  "exceeding  glad"  by  the 
return  of  a  father  or  mother,  a  brother  or  sister,  a 
child  or  a  companion.  It  has  been  permitted  me  to 
see  not  a  few  come  up  out  of  the  deepest  darkness  of 
mental  and  sometimes  spiritual  night,  into  the 
blessed  daylight  of  hope  and  joy  and  peace.  Some 
such  I  have  been  allowed  to  meet  in  their  own  homes, 
filled  with  overflowing  gratitude  and  thankfulness. 

What  I  have  seen  and  heard  has  left  a  firm  convic- 
tion in  my  mind  that  asylums  and  hospitals  for  the 
insane  have  done  much  for  the  relief  of  one  of  the 


WITH  THE   INSANE.  11 

most  pitiable  forms  of  human  suffering.  I  believe  it 
is  possible  for  these  institutions  to  do  more  and  bet- 
ter in  the  future.  Improvements  in  means  and 
methods  are  to  be  expected  in  these,  as  in  all  other 
human  institutions.  During  the  present  century 
wonderful  progress  has  been  made  in  many  directions. 
Much,  doubtless,  still  remains  to  be  accomplished. 

To  show  what  has  already  been  done,  I  have  intro- 
duced several  short  historical  chapters,  the  matter  of 
which  is  borrowed  and  condensed  from  various 
authors,  to  whom  I  desire  in  this  way  to  give  all 
due  credit. 

Observation  has  also  impressed  me  with  the  belief 
that  much  insanity  might  be  prevented.  This  is 
true,  I  suppose,  of  most  forms  of  disease,  but  it  seems 
to  me  to  be  peculiarly  true  in  respect  to  mental  dis- 
orders. The  opinion  is  very  general  that  insanity 
has  been  for  many  years,  and  still  is,  increasing. 
While  I  do  not  think  the  rate  of  increase  is  so  great 
as  census  reports  appear  to  indicate,  it  is  yet  evidently 
sufficient  to  justify  alarm,  and  to  call  for  serious  in- 
quiry into  the  causes  and  for  means  of  prevention. 
The  object  of  the  later  chapters  is  to  turn  the  thoughts 
of  parents,  teachers,  and  others  who  are  especially 
responsible  for  the  training  of  the  young,  in  that 
direction. 


12  TWENTY-FIVE   YEARS 


CHAPTER  II. 

INSANITY   AND   ITS    TREATMENT   AMONG   THE 
ANCIENTS. 

Our  knowledge  of  insanity  among  the  earliest  his- 
torical peoples  is  very  limited  and  unsatisfactory. 
Incidental  allusions  in  the  oldest  preserved  writings, 
both  sacred  and  secular,  indicate  that  the  disease 
manifested  itself,  at  least  occasionally,  even  in  the 
ages  of  primitive  civilization  and  habits.  Everything 
which  may  be  said  as  to  the  probable  frequency  of 
such  manifestations  is  pure  conjecture,  based  upon 
supposed  conditions  of  society,  modes  of  life,  and 
employments. 

The  legislation  of  Moses  makes  no  mention  of 
lunacy,  but  references  are  found  in  the  Hebrew  Script- 
ures to  forms  of  madness  which  were  obviously  attacks 
of  insanity.  King  Saul  undoubtedly  suffered  from 
periodical  outbursts  of  some  species  of  mental  dis- 
order. His  conduct  on  several  occasions  can  be 
explained  on  no  other  hypothesis.  His  jealousy, 
irritability,  and  unreasoning  acts  of  violence  exhibit 
peculiarities  readily  recognized  by  those  who  are 
familiar  with  the  behavior  of  insane  men.  The 
employment  of  music  for  the  relief  of  Saul,  when 
seized  by  these  paroxysms,  enables  us  to  discover 
one  of  the  means  used  for  the  cure  or  mitigation  of 
insanity  in  that  age. 


WITH   THE    INSANE.  13 

David,  when  his  life  was  in  danger  at  the  court  of 
Achish,  feigned  madness.  This  instance  of  assumed 
imbecility,  for  such  seems  to  have  been  the  type  of 
David's  insanity,  has  a  twofold  interest.  It  justifies 
us  in  concluding  that  cases  of  real  imbecility  were  so 
frequent  as  to  fall  under  general  observation.  David 
could  not  have  simulated  successfully  conduct  with 
which  he  had  not  a  tolerably  good  acquaintance ;  and 
King  Achish  would  not,  at  once,  have  pronounced  him 
mad  if  he  had  not  often  seen  madmen  before.  The 
inference  is  unavoidable  that  some  forms  of  insanity 
were  common  in  that  part  of  the  ancient  Ea'st. 

The  case  of  David  throws  light  also  upon  the  prob- 
able treatment  of  the  insane  among  the  Hebrews  and 
Philistines.  Among  them,  as  among  some  other 
nations  of  antiquity,  it  seems  evident  that  a  certain 
degree  of  respect  and  reverence  was  felt  for  persons 
afflicted  with  some  types  of  madness.  They  were 
believed  to  have  been  touched  by  the  finger  of  some 
divinity,  and  to  be  under  his  protection  and  guidance. 
They  were,  in  some  cases,  supposed  to  be  partially 
inspired  and  to  be  able  to  utter  oracles.  In  other 
cases,  they  were  believed  to  be  suffering  special  pun- 
ishment, inflicted  directly  and  immediately  by  a  deity. 
Consequently,  to  lay  human  hands  on  them  in  vio- 
lence was  impiety,  and  might  bring  divine  vengeance 
down  upon  the  head  of  the  offender. 

Where  such  feelings  and  opinions  prevailed,  the 
mild  and  harmless  insane  were  allowed  to  go  at  large, 


14  TWENTY-FIVE   YEARS 

and  were  hedged  about  with  a  sort  of  invisible  but 
efficient  protection.  David's  pretended  madness,  there- 
fore, was  sure  to  afford  him  temporary  security  from 
any  serious  ill-treatment,  and  to  give  him  opportunity 
to  make  his  escape.  The  violently  insane  were  with- 
out doubt  at  that  time,  as  they  certainly  were  at  a 
later  period  among  the  Jews,  confined  with  fetters 
and  chains. 

The  condition  of  the  insane  in  other  countries  of 
the  ancient  East  seems  to  have  been  essentially  the 
same  as  in  Syria  and  Palestine.  Nebuchadnezzar 
suffered,  for  seven  years,  from  an  attack  of  that  form 
of  lunacy  which  is  now  known  as  lycanthropia  or 
lycanthropy.  This  species  of  insanity  is  not  uncom- 
mon, and  under  its  influence  the  poor  victim  imagines 
himself  to  be  a  beast,  and  behaves,  as  far  as  possible, 
like  the  animal  into  which  he  believes  he  has  been 
transformed.  If  the  mightiest  monarch  of  the  time, 
while  laboring  under  a  most  pitiable  delusion,  was 
turned  out  to  wander  over  the  fields  with  the  cattle, 
to  eat  grass  like  the  ox,  to  go  with  uncut  nails  and 
uncombed  hair  and  beard,  to  be  unsheltered  and 
totally  neglected,  it  is  not  difficult  to  determine  the 
amount  and  kind  of  care  and  consideration  bestowed 
upon  the  insane  in  Babylonia  and  in  the  other  great 
Oriental  kingdoms. 

In  Egypt,  and  also  in  Greece,  it  is  said  that  some 
temples,  dedicated  to  the  worship  of  certain  deities, 
were  open  for  the  admission  of  persons  of  disordered 


WITH  THE   INSANE.  15 

intellects.  If  this  were  so,  the  practice  probably  orig- 
inated in  the  belief  that  insanity  was  caused  by  the 
direct  purpose  and  act  of  some  agency  higher  than 
man.  It  is,  moreover,  affirmed  by  a  few  writers, 
but  upon  questionable  authority,  that  some 
of  the  most  enlightened  of  the  Greek  physicians 
employed  humane  and  scientific  remedies  in  their 
treatment  of  insanity.  As  a  rule,  in  Egypt,  Greece, 
and  Italy,  the  insane  fared  no  better  than  in  the  East. 
Everywhere  they  were  treated  with  abuse  or  neglect. 
If  inoffensive,  they  were  permitted  to  wander  at  will ; 
if  violent  and  dangerous,  they  were  loaded  with  chains 
and  fetters. 

Hospitals  and  asylums  were  unknown  in  the  old 
world.  Near  the  temples  of  JEsculapius,  the  god  of 
medicine  and  patron  of  physicians,  houses  were  some- 
times built  for  the  reception  of  visitors  who  came  to 
seek  advice  and  direction  of  the  deity,  either  for  them- 
selves or  for  suffering  friends.  But  these  were 
merely  places  of  shelter  and  refuge,  and  not  hospitals, 
in  the  modern  acceptation  of  the  name,  where  medi- 
cal care  and  attendance  could  be  had.  Organized 
charities,  either  of  a  public  or  private  character,  for 
the  support  or  relief  of  the  aged,  the  unfortunate,  the 
destitute,  the  sick,  the  blind,  or  the  insane,  had  no 
place  in  the  civilizations  which  preceded  the  Christian 
era 


TWENTY-FIVE   YEARS 


CHAPTER  III. 

THE    INSANE    DURING-   THE    EARLY    CHRISTIAN 
CENTURIES. 

In  the  olden  times  men  loved  their  families,  their 
friends,  their  neighbors,  and,  in  a  less  degree,  their 
countrymen.  .The  feelings  of  pity  and  compassion 
existed  in  their  souls.  The  impulses  of  good-will, 
and  benevolence,  and  charity  were  not  wanting.  But 
love,  and  pity,  and  charity  were  confined  within  very 
narrow  bounds.  Strangers  were  enemies,  and  enemies 
might  be  hated  and  killed  without  blame.  Men  were 
not  regarded,  protected,  or  cared  for,  simply  because 
they  were  men.  The  great  majority  "  went  by  on  the 
other  side"  of  wounded  and  bleeding  humanity,  unless 
the  kinship  was  very  close  and  the  tax  upon  resources 
and  effort  was  very  light. 

The  "Galilean"  imposed  "a  new  commandment" 
upon  his  followers,  and  emphasized,  if  He  did  not 
introduce,  a  new  principle  of  human  action.  His 
disciples  were  to  "love  one  another,"  not  because 
they  were  of  kindred  blood,  not  because  they  were 
friends,  neighbors,  or  countrymen ;  but  because 
they  were  of  one  common  humanity,  children 
of  the  same  divine  Father.  There  was  to  be  in  His 
kingdom  no  Jew  nor  Gentile,  no  Greek  nor  Barbarian, 
no  bond  nor  free,  but  only  citizens  and  brethren. 


WITH    THE    INSANE.  17 

Moreover,  the  love,  or  charity,  of  the  new  com- 
mandment was  intensely  practical  in  its  character. 
It  was  not  a  mere  emotion  or  sentiment.  It  was  not 
to  find  expression  in  words  alone.  In  deeds  it  was 
to  be  embodied  and  manifested.  The  hungry  were 
to  be  fed,  the  naked  were  to  be  clothed,  the  sick  were 
to  be  healed.  Blind  eyes  were  to  be  opened,  deaf 
ears  were  to  be  unstopped,  lepers  were  to  be  cleansed, 
and  demons  to  be  cast  out.  These  works  of  benef- 
icence and  mercy  were  to  be  done  in  all  lands  and 
for  all  peoples. 

The  first  manifestations  of  Christian  charity  were 
unorganized.  Individuals  helped,  according  to  their 
means  and  opportunities,  other  individuals.  Then 
small  local  bodies  helped  the  poor  and  unfortunate 
immediately  about  them.  Gradually  the  work  became 
reduced  to  system  and  order  by  the  union  of  these 
local  societies  over  a  considerable  extent  of  territory. 
As  means  increased,  hospitals  and  other  public  recep- 
tacles for  the  needy,  the  sick,  and  the  suffering  began, 
for  the  first  time  in  the  history  of  the  world,  to  be 
built  and  opened  to  persons  of  all  classes  and  creeds. 

The  first  hospital  is  said  to  have  been  erected  by  a 
Christian  woman  in  Rome  in  the  fourth  Christian 
century.  Soon  after,  others  were  founded  in  all  the 
great  centers  of  the  Roman  empire.  Asylums  were 
established  for  lepers,  for  blind  beggars,  for  the  infirm 
and  aged,  indeed,  for  almost  every  form  of  misfortune 
and  misery.  The  church  in  Antioch,  in  the  time  of 
2 


18  TWENTY-FIVE   YEARS 

St.  Chrysostom,  besides  caring  for  the  sick  and 
strangers,  supported  three  thousand  widows  and 
young  girls.  About  the  same  period  the  church  in 
Rome  provided  for  fifteen  hundred  widows  and  other 
indigent  persons,  at  an  expense  of  not  less  than 
eighteen  thousand  dollars  a  year.  Other  churches, 
in  other  great  cities,  engaged  with  equal  zeal  in  the 
same  work  of  charity  and  mercy.  A  single  collection 
in  Carthage  for  the  ransom  of  prisoners  yielded  four 
thousand  dollars,  although  the  Christians  in  that  city 
were  neither  numerous  nor  wealthy.  The  laws  of  the 
new  societies  made  it  the  duty  of  the  officers  and 
overseers  "  to  take  care  for  the  maintenance  of  all 
who  were  in  distress,  and  to  let  none  of  them  want ; 
to  supply  to  orphans  the  care  of  parents,  to  widows 
the  care  of  husbands,  to  help  to  marriage  those  ready 
for  marriage,  to  procure  work  for  those  out  of  work, 
to  show  compassion  to  those  incapable  of  work,  to 
provide  a  shelter  for  strangers,  food  for  the  hungry, 
drink  for  the  thirsty,  visits  for  the  sick,  and  help  for 
the  prisoners." 

In  all  this  grand  development  of  practical  love, 
charity,  and  benevolence,  the  grandest  which  the 
world  has  ever  seen,  the  insane  seem  to  have  found 
no  remembrance,  or,  if  any,  so  little  that  it  has 
escaped  the  notice  of  all  historians.  Those  bereft  of 
sight  were  sheltered  and  fed ;  those  more  sorely  bereft 
of  reason  were  left  to  go  homeless  and  hungry. 
Lepers,  though  types  of  physical  and  moral  unclean- 


WITH    THE    INSANE.  19 

ness,  shared  a  charity  which  was  denied  to  the  maniac. 
This  apparent  inconsistency  can  not  be  explained  on 
the  supposition  that  the  insane  were  so  few  as  to  be 
overlooked,  or  that  their  sufferings  were  so  incon- 
siderable as  to  need  no  relief  and  to  make  no  appeal 
to  the  feelings  of  pity  and  compassion.  The  mystery 
finds  its  probable  solution  in  quite  another  direction. 
The  ancient  belief  that  the  insane  were  influenced 
by  spiritual  agencies,  and  were,  in  some  way,  pecu- 
liarly related  to  superhuman  powers,  has  already 
been  alluded  to.  Nearly  allied  to  this  doctrine  was 
the  belief  in  witchcraft  and  demoniacal  possession. 
The  early  Christians  received  these  beliefs  by  natural 
inheritance,  and  they  have  been  perpetuated,  by  tra- 
dition and  by  an  intuitive  tendency  of  the  human 
mind  towards  the  strange  and  marvelous,  down  to  a 
period  within  the  memory  of  some  now  living.  More- 
over, the  sacred  writings,  both  of  the  Old  and  New 
Testaments,  as  usually  and  most  literally  interpreted, 
seemed  to  teach  that  demons  could  and  did,  by  some 
means,  enter  into  the  human  body,  if  not  into  the 
.soul.  Probably  the  most  generally  accepted  doctrine 
of  the  present  day,  among  those  who  adhere  to  a 
pretty  literal  interpretation  of  the  Scriptures,  is  that 
such  power  of  possession,  once  permitted  to  demons, 
was  limited  to  certain  peculiar  periods,  conditions, 
and  circumstances,  and  has  not  been  extended  indefi- 
nitely into  the  Christian  centuries.  The  members 
and  teachers  of  the  early  churches  saw  no  reason  for 


20  TWENTY-FIVE   YEARS 

supposing  such  limitation.  Demons  and  other  infer- 
nal powers  were  as  mighty,  and  as  much  to  be 
dreaded,  hated,  and  resisted  in  the  fourth,  and  even 
in  the  seventeenth,  as  in  the  first  centuries.  To  express 
a  doubt  of  the  reality  of  witchcraft  was  to  expose 
one's  self  to  the  charge  of  Sadduceeism. 

Now,  many  of  the  external  manifestations  of  acute 
mania  and  epilepsy  bear  a  most  marked  resemblance 
to  the  conduct  of  persons  who  were  believed  to  be  pos- 
sessed. Consequently  maniacs,  and  those  of  the 
insane  laboring  under  many  delusions,  could  not  be 
distinguished  from  demoniacs.  It  was  not  unnatural, 
therefore,  that  the  fear,  distrust,  and  detestation  felt 
towards  men  and  women  believed  to  be  in  most  inti- 
mate association  with  evil  spirits,  or  even  to  be 
inhabited  by  demons,  should  be  turned  towards  the 
unfortunate  victims  of  insanity,  since  the  two  classes 
had,  apparently,  so  many  characteristics  in  common. 
Here,  without  much  reasonable  doubt,  is  found  the 
true  cause  why,  through  many  sad  and  desolate  ages, 
the  insane  were  left  almost  entirely  outside  the  widely 
extended  arms  of  human  and  Christian  charity. 
They  received  hatred  in  place  of  love.  They  were 
punished  rather  than  pitied.  Scourges,  chains,  and 
fetters  were  given  them  instead  of  food,  and  medicine, 
and  shelter.  Occasionally  the  older  belief  that  the 
harmless  and  inoffensive  insane  were  inspired  and 
protected  by  the  Deity  and  by  good  spirits,  secured 
special  favor  and  peculiar  consideration  for  certain 


WITH    THE    INSANE.  21 

classes  of  lunatics,  and  certain  forms  of  lunacy. 
During  the  confusions,  and  disorders,  and  violence  of 
the  times  when  society  seemed  resolving  itself  into  its 
original  elements,  many  more  fled  away  from  the 
cities  and  towns,  and  dwelt  alone  in  caves  and  in 
other  wild  and  secluded  places.  In  the  warm  cli- 
mate of  the  Bast  and  South  nature  demanded  but 
little  clothing.  Their  garments  were  of  the  coarsest 
and  rudest  kind,  and  their  food  simple  and  scanty. 
Personal  cleanliness  was  not  esteemed  among  the 
virtues,  and  their  hair  and  beard  were  allowed  to 
grow  long  and  shaggy.  In  many  cases,  advancing 
years  gave  them  a  sort  of  rustic  dignity,  and  common 
opinion  ascribed  to  them  peculiar  sanctity  and 
wisdom. 

Living  thus  apart,  with  little  human  intercourse, 
with  no  books,  possessed  with  the  generally  received 
belief  that  evil  spirits  frequented  the  wilderness  and 
deserts,  they  easily  fell  into  an  unbalanced  state  of 
mind.  They  became  subject  to  hallucinations  and 
delusions.  They  had  struggles  and  contests  with 
demons.  They  were  visited,  helped,  and  comforted 
by  good  angels.  They  saw  and  heard  most  marvel- 
ous things.  Coming  occasionally  out  of  their  wild 
retreats,  they  wandered  over  the  country,  and  through 
the  streets  of  villages  and  cities.  They  were  received 
with  great  respect  and  reverence,  not  only  by  the 
common  people,  but  by  the  clergy  and  by  others  in 
high  places  of  influence  and  authority.  Their  disor- 


22  TWENTY-FIVE   YEARS 

dered  fancies  were  accepted,  to  a  considerable  extent, 
as  veritable  accounts  of  actual  occurrences,  and  were 
embodied  and  preserved  in  the  legends  and  lives  of 
saints.  Insane  persons  of  this  class,  and  of  a  few 
other  kindred  classes,  were  treated,  not  indeed  wisely, 
but  with  humanity  and  kindness.  Whatever  suffer- 
ings they  endured  were  self-inflicted.  For  once 
credulity  and  superstition  performed  the  offices  of 
compassion  and  charity. 

Equally  harmless  and  innocent  victims  of  other 
forms  of  insane  delusion  were  less  fortunate.  In 
place  of  reverence  and  tenderness,  they  were  treated 
with  punishments,  and  tortures,  and  death.  It  is  not 
uncommon  now  for  insane  men  and  women  to  imag- 
ine themselves  to  be  divine  personages.  Such 
delusions  are  not  considered,  at  the  present  day,  more 
dangerous  or  more  blameworthy  than  a  thousand 
others.  In  earlier  centuries  less  lenient  views  were 
entertained  of  such  vagaries  of  diseased  minds. 
They  were  believed  to  involve  the  sin  of  impiety  and 
blasphemy,  and  to  deserve  the  heaviest  penalties  and 
the  most  cruel  torments,  both  here  and  hereafter. 
To  pity  or  spare  such  monsters  of  wickedness  was  to 
incur  a  degree  of  guilt  hardly  less  than  their  own. 
The  mercy  of  a  peaceful  and  painless  death  was 
denied  them.  Two  or  three  examples  will  show  the 
temper  of  the  times. 

"  In  the  year  1300,  a  beautiful  English  girl 
appeared  at  Milan,  laboring  under  the  delusion  that 


WITH    THE    INSANE.  23 

she  was  the  Holy  Ghost,  incarnated  for  the  redemp- 
tion of  women."  Instead  of  finding  pity  and  refuge 
in  an  asylum,  she  suffered  death  by  fire.  A  Span- 
iard, declaring  himself  to  be  a  brother  of  the  archan- 
gel Michael,  and  affirming  that  he  was  to  occupy  the 
high  position  in  heaven  which  Satan  had  forfeited 
and  lost,  was  burned  alive  by  the  command  of  the 
Archbishop  of  Toledo.  The  death  of  Joan  of  Arc 
affords  another  illustration  of  native  barbarism 
intensified  by  political  and  religious  hate.  Great 
numbers  of  the  common  people  perished,  year  by 
year,  after  having  been  exposed  to  every  conceivable 
species  of  insult  and  torture.  The  phenomena  and 
treatment  of  mediaeval  and  modern  witchcraft, 
so-called,  present  a  marvelous  admixture  of  honest 
credulity,  of  wicked  deception,  of  heartless  and  fiend- 
ish cruelty,  and  of  the  illusions  and  delusions  of 
insanity.  The  insane  shared  the  hatred  and  fate  of 
the  wicked. 


CHAPTER  IV. 

THE   FIRST  HOSPITALS   AND   ASYLUMS  FOR  THE 
INSANE,  AND  THEIR  CHARACTER. 

In  the  sixth  centur}7  a  house  of  shelter  or  refuge 
is  said  to  have  been  opened  at  Jerusalem  for  insane 
monks.  Amid  the  turmoil  of  that  period  large  num- 
bers of  these  monks  were  wandering  over  the  East 


24  TWENTY-FIVE   YEARS 

So  far  as  now  known,  no  hospital  or  asylum  for  the 
insane  existed  in  Europe  till  after  the  year  1400. 

In  1409,  a  man  of  humane  spirit  observed  the  rab- 
ble following  and  hooting  at  some  maniacs  in  the 
streets  of  the  city  of  Valencia,  in  Spain.  Moved 
with  compassion,  he  secured  the  erection  of  a  house 
into  which  they  might  be  received  and  protected 
from  insult  and  abuse.  In  1425,  an  asylum  was 
founded  in  Saragossa ;  in  1436,  others  in  Seville  and 
Valladolid,  and  one  in  Toledo  in  1483.  Previous  to 
this  time  the  Mohammedans  had  made  some  organ- 
ized provision  for  the  insane  among  them.  A  writer 
of  the  seventh  century  states  that  several  buildings 
were  erected  for  lunatics  in  Fez,  in  which  the  more 
violent  were  confined  in  chains.  It  is  reported  that 
a  hospital  was  founded  in  Cairo  in  1304.  Doubtless 
receptacles  existed  in  other  Mohammedan  cities.  Of 
the  military  orders,  the  Knights  of  Malta  alone 
admitted  insane  patients  into  their  hospitals.  An 
asylum  was  built  at  Eome  in  1548,  and  gradually 
receptacles  were  opened  in  all  the  countries  of 
Europe. 

In  England  the  first  house  of  a  public,  or  semi- 
public,  character  established  for  the  insane,  was 
Bethlehem  Hospital,  in  London.  Some  shadows  of 
doubt  and  uncertainty  have  gathered  about  the  ori- 
gin of  this  institution.  Statements  put  forth  by  dif- 
ferent writers  do  not  harmonize  with  each  other. 
The  hospital  seerns  to  have  been  founded,  about 


WITH    THE    INSANE.  25 

1247,  as  a  priory,  or  place  of  refuge,  for  the  relig- 
ious order  of  St.  Mary  of  Bethlehem.  There  is  no 
satisfactory  evidence  of  the  admission  of  insane 
patients  until  about  the  year  1400.  At  that  time,  in 
consequence  of  some  misbehavior  of  an  officer,  a 
royal  commission  examined  into  the  condition  of 
the  hospital.  Their  report  disclosed  the  fact  that  six 
men,  who  were  lunatics,  were  found  there,  and  the  in- 
ventory of  furniture  and  other  appurtenances  includes 
"six  chains  of  iron,  with  six  locks,  four  pairs  of  manacles 
of  iron,  and  two  pairs  of  stocks."  These  articles  are 
only  too  suggestive  of  the  treatment  to  which  the 
unfortunate  inmates  were  probably  subjected.  The 
next  asylum  in  England  was  not  opened  till  1751, 
and  up  to  the  year  1792  only  fifteen  hospitals  of  all 
kinds  for  the  insane  had  been  established  in  Great 
Britain. 

It  is  a  matter  of  grave  doubt  whether  the  establish- 
ment of  these  so-called  hospitals  and  asylums  im- 
proved the  condition  and  treatment  of  persons  afflicted 
with  mental  disease.  They  were  perhaps  necessary 
steps  along  the  road  of  slow  progress  towards  humane 
and  scientific  treatment.  But  they  were  little  else 
than  prisons,  and  most  of  them  were  prisons  of 
the  worst  description.  They  were  erected  and  filled, 
not  from  considerations  of  humanity  and  mercy 
towards  their  inmates,  but  for  the  protection  of  society 
and  the  relief  of  relatives  and  friends.  In  not  a  few 
cases  the  buildings  were  absolutely  unfit  for  habita- 


26  TWENTY-FIVE   YEARS 

tions  of  the  vilest  animals,  mere  gloomy,  frightful 
dens.  Men,  and  sometimes  women,  cowered  in  nar- 
row, cold,  damp  cells  of  stone,  without  light  or  air, 
furnished  with  only  a  bed  of  straw,  which  was  rarely 
renewed.  In  some  receptacles  the  attendants  were 
convicts  from  prisons,  and  the  wretched  insane  were 
entirely  at  their  mercy.  They  were  heavily  chained 
and  fettered.  Day  and  night  the  places  echoed  with 
cries,  howlings,  and  clankings  of  chains.  Not  all  the 
hospitals  were  so  terrible,  but  even  the  best  of  those 
days  would  not  now  be  tolerated  for  an  hour.  One 
would  be  glad,  for  the  honor  of  our  common  human- 
ity, to  tear  out  and  destroy  the  historic  pages  upon 
which  such  humiliating  records  are  found ;  but  it  is 
necessary  to  recall  and  open  them  in  order  to  estimate 
justly  the  rate  and  character  of  the  progress  which 
the  present  century  has  made  in  the  care  and  treat- 
ment of  insanity  and  the  insane. 

For  many  years  Bethlem  Hospital,  or  Bedlam,  as 
it  was  usually  called,  was  one  of  the  public  shows  of 
London.  It  was  visited  for  the  same  reasons,  and 
with  the  same  feelings  and  curiosity,  with  which  the 
menagerie  and  the  cock-pit  were  frequented.  The 
admission  fee  was  one  or  two  pennies,  and  the  income 
from  this  source  was  sometimes  two  thousand  dollars 
annually.  Strange  to  say,  this  barbarous  custom 
continued  as  late  as  1770,  and,  from  incidental  allu- 
sions in  English  literature,  it  is  evident  that  all 
classes  regarded  maniacs  just  as  they  did  caged  and 


WITH    THE    INSANE.  27 

chained  wild  beasts.  Evelyn  writes  in  one  place, 
"I  stepped  into  Bedlam,  where  I  saw  several  poor 
creatures  in  chains ;  one  of  them  was  mad  with  mak- 
ing verses."  Ned  Ward, in  his  "London  Spy,"  gives 
an  extended  account  of  a  visit  to  the  place.  "We 
were  admitted  in  through  an  iron  gate,  within  which 
sat  a  brawny  Cerberus  of  an  indigo  color,  leaning 
upon  a  money-box;  we  turned  in  through  another 
iron  barricade,  where  we  heard  such  a  rattling  of 
chains,  drumming  of  doors,  ranting,  hollowing,  sing- 
ing, and  running,  that  I  could  think  of  nothing  but 
Don  Quevedo's  Vision,  where  the  lost  souls  broke 
loose  and  put  hell  in  an  uproar." 

In  one  of  his  famous  pictures  in  the  "  Rake's  Prog- 
ress," Hogarth  represents  two  ladies  of  fashion  visit- 
ing this  hospital  while  the  keeper  is  putting  fetters 
upon  the  poor  rake.  Near  by  stands  a  person  sup- 
posed to  be  the  doctor,  and  the  miserable  woman 
who  has  followed  the  rake  in  his  downward  course 
is  looking  on.  A  conspicuous  figure  in  the  picture  is 
a  maniac,  lying  on  straw  in  one  of  the  cells,  with  a 
chain  distinctly  in  view.  A  man,  who  imagines  him- 
self a  king,  is  seen  in  another  cell,  wearing  a  crown 
of  straw.  Several  other  insane  characters  can  be 
readily  recognized,  among  them  an  astronomer,  a 
musician,  and  a  high  ecclesiastic.  The  whole  repre- 
sentation has  a  profound  historical  interest.  Hogarth 
seems  to  have  drawn  from  life. 


28  TWENTY-FIVE   YEARS 

Of  medical  treatment,  in  the  proper  sense  of  that 
term,  there  was  none  in  any  of  these  institutions. 
Of  moral  means  for  restoring  "  minds  diseased,"  it  is 
difficult  to  discover  that  any  were  employed.  Over 
the  portals  of  these  abodes  of  misery  might  well  have 
been  written,  "  Who  enters  here  leaves  hope  behind." 

The  early  history  of  the  treatment  of  the  insane  in 
the  United  States  is  little  else  than  a  repetition  of 
European  history  during  the  same  time.  Until  very 
late  in  the  colonial  period  no  special  provisions  were 
made  anywhere  in  the  country  for  the  cure  or  the 
comfort  of  lunatics.  No  hospitals  or  asylums  existed. 
The  insane  wandered  abroad,  were  cared  for  by 
friends,  or  were  confined  in  jails,  almshouses,  stables, 
and  out-buildings.  They  endured  neglect,  abuse, 
chains,  fetters,  filth,  and  frost.  Among  us,  as  among 
all  other  peoples,  exceptional  cases  received  humane 
and  Christian  consideration  and  care;  but  here,  as 
elsewhere,  the  great  majority  suffered  without  pity 
and  died  without  consolation.  Investigations  in  New 
York  and  in  some  other  States,  in  the  early  years  of 
the  present  century,  proved  that  all  the  horrors  of 
European  receptacles  were  duplicated  in  our  own 
jails,  poor-houses,  and  other  places  of  detention,  both 
private  and  public. 

The  first  hospital  into  which  insane  patients  were 
regularly  admitted,  in  the  then  colonies,  was  the 
Pennsylvania  General  Hospital,  opened  in  1752. 
Only  a  limited  number  were  received.  It  is  claimed, 


WITH    THE    INSANE.  29 

I  hope  with  truth,  that  the  treatment  of  the  insane  in 
that  institution  anticipated,  in  a  good  degree,  the 
reforms  and  improvements  which  began  nearly  half 
a  century  later  in  France  and  England.  It  is  certain 
that  the  atmosphere  of  Philadelphia  was  then  thor- 
oughly permeated  by  the  humane  and  kindly  influ- 
ence of  the  Society  of  Friends,  and  that  Dr.  Franklin 
was  greatly  interested  in  the  establishment  and  man- 
agement of  this  Hospital.  The  first  asylum,  exclu- 
sively for  the  insane,  was  built  by  the  colony  of 
Virginia,  in  1773,  at  Williamsburg.  This  was  estab- 
lished and  supported  at  public  expense,  and  still 
remains  as  the  Eastern  Asylum  of  that  State.  Insane 
patients  were  received  into  the  hospital  at  the  city  of 
New  York  as  early  as  1797.  Out  of  that  institution 
grew  the  present  Bloomingdale  asylum,  opened  in 
1821.  "  The  Friends'  Asylum,  opened  for  the  relief 
of  persons  deprived  of  the  use  of  their  reason,"  was 
established  near  Philadelphia  in  1817.  The  McLean 
asylum  at  Somerville,  near  Boston,  was  opened  in 
1818.  A  small  asylum  was  erected  by  the  State  of 
South  Carolina,  at  Columbia,  in  1822.  The  Con- 
necticut Eetreat  for  the  Insane,  at  Hartford,  was 
founded  in  1824,  and  the  Kentucky  asylum,  at 
Lexington,  was  established  in  the  same  year.  Since 
this  last  date  numerous  hospitals  and  asylums,  both 
public  and  private,  have  been  founded  in  all  parts  of 
the  United  States. 


TWENTY-FIVE   YEARS 


CHAPTER  V. 

CURIOUS   SUPERSTITIONS,  AND   STRANGE   METHODS   OF 
TREATING  THE  INSANE. 

Until  insanity  took  its  place  among  recognized 
diseases  of  the  physical  organism,  its  origin  was 
shrouded  in  mystery  which  excited  and,  at  the  same 
time,  baffled  inquiry  and  investigation.  Its  phenom- 
ena were  so  strange,  so  utterly  inexplicable  by  any 
known  laws  of  mental  action,  that,  not  very  unnatu- 
rally, the  remedies  employed  for  its  cure,  especially 
by  the  ignorant  and  superstitious,  were  of  the  most 
absurd  and  irrational  character.  The  use  of  such 
means  may  have  had  a  beginning  in  some  lucky  acci- 
dent, or  in  some  sudden  caprice  as  wild  as  the  vaga- 
ries of  insanity  itself.  Once  begun,  the  practice 
could  easily  be  kept  alive.  Soon  tradition  would 
come  in  to  repeat  marvelous  tales  of  its  efficacy,  and 
to  exaggerate  the  evidences  of  its  power  and  virtue. 
Habits,  customs,  rites,  however  fantastic  and  even 
repulsive,  thoroughly  established  among  a  rural  and 
unenlightened  people,  have  great  tenacity  of  life. 
They  survive  in  spite  of  the  hottest  fires  of  persecu- 
tion, and  the  plainest  teachings  of  science  and  philos- 
ophy. Like  the  seeds  of  noxious  plants,  they  take 
root  and  spring  up  in  the  most  unexpected  places, 
and  under  circumstances  apparently  the  most  unpro- 


WITH    THE    INSANE.  31 

pitious.  In  regard  to  matters  of  this  kind,  our  own 
age,  with  all  its  self-laudation,  has  little  reason  for 
casting  reproaches  upon  earlier  times. 

We  can  claim  for  our  Saxon  ancestors,  no  more 
than  for  our  Celtic,  any  superabundance  of  either 
humanity  or  wisdom  in  their  dealings  with  the  crimi- 
nal and  the  unfortunate.  The  prescriptions  of  their 
physicians,  educated  in  the  learning  of  their  times, 
were  singular  admixtures  of  castigation,  medicine, 
superstition,  and  religion.  Emetics,  cathartics,  herbs, 
and  masses  were  administered  with  impartial  liberal- 
ity. A  man  troubled  with  hallucinations  was  fed 
with  properly  prepared  wolf's  flesh.  Mixtures  of  ale 
and  holy  water  were  given  to  possessed  persons. 
Scourgings  and  chains  found  frequent  use.  The 
moon  had  influence  both  upon  the  disease  and  upon 
the  efficacy  of  remedies. 

Faith  in  the  curative  influence  of  the  waters  of  cer- 
tain wells  and  springs  was  very  wide-spread  and  long 
continued.  Indeed,  this  faith,  perhaps  slightly  dis- 
turbed and  a  little  weakened,  still  survives  in  obscure 
nooks  and  corners  of  the  Old  World,  and  possibly  in 
the  New.  Insane  patients  were  plunged  into  these 
waters  with  appropriate  and  mystic  rites.  Into  one 
pool  it  was  prescribed  that  the  victim  should  be 
thrown  backwards,  should  be  violently  tossed  up  and 
down  by  strong  attendants  until  thoroughly  ex- 
hausted, then  conveyed  to  a  church  near  at  hand, 
that  masses  might  be  sung  over  him.  If  one  expe- 


32  TWENTY-FIVE  YEARS 

* 

rience  of  this  sort  did  not  effect  a  cure,  the  treatment 
was  repeated.  This  method  of  cure  was  practiced,  in 
Great  Britain,  late  in  the  last  century. 

Scotland  has  been,  probably,  more  celebrated  than 
any  other  country  for  its  mind-healing  wells  and 
springs.  The  superstitious  observances  connected 
with  some  of  these  have  hardly  yet  entirely  dis- 
appeared. St.  Fillan's  pool  in  Perthshire  was 
one  of  the  most  famous  of  these.  In  "Marmion," 
Scott  makes  one  of  his  characters  say : — 

"Then  to  St.  Fillan's  blessed  well, 
Whose  spring  can  frenzied  dreams  dispel, 
And  the  crazed  brain  restore." 

Into  this  pool  patients  were  plunged  three  times, 
then  securely  bound  hand  and  foot,  and  left  alone 
for  the  night  in  a  chapel  near  by.  If  the  poor 
maniac  could  contrive  to  free  himself  from  the  cords, 
his  recovery  was  confidently  expected;  if  he  was 
found  still  tied,  little  hope  was  entertained  of  his 
restoration.  Sometimes  death  followed  the  exhaus- 
tion produced  by  the  process,  and  brought  a  happy 
deliverance  from  troubles. 

As  recently  as  1793,  it  is  stated  that  "about  two 
hundred  persons,  afflicted  with  insanity,  were 
brought  to  try  the  salutary  influence  of  these  sacred 
waters  annually." 

In  Ross-shire,  on  a  small  island  in  Loch  Maree,  is 
another  famous  well.  Whittier,  in  his  inimitable 


WITH  THE   INSANE.  33 

manner,  has  sung  the  virtue  of  these  waters,     fie 
says,— 

"  Calm  on  the  breast  of  Loch  Maree 

A  little  isle  reposes ; 
A  shadow,  woven  of  the  oak 
And  willow,  o'er  it  closes. 

"Within,  a  Druid's  mound  is  seen, 
Set  round  with  stony  warders; 
A  fountain,  gushing  through  the  turf, 
Flows  o'er  the  grassy  borders. 

' '  And  whoso  bathes  therein  his  brow, 

With  care  or  madness  burning, 
Feels  once  again  his  healthful  thought 
And  sense  of  peace  returning." 

Pennant,  who  visited  the  spot  in  1769,  writes, 
"  The  curiosity  of  the  place  is  the  well  of  the  saint, 
of  power  unspeakable  in  cases  of  lunacy.  The 
patient  is  brought  into  the  sacred  island,  is  made  to 
kneel  before  the  altar,  where  his  attendants  leave  an 
offering  of  money;  he  is  then  brought  to  the  well 
and  sips  some  of  the  holy  water ;  a  second  offering  is 
made ;  that  done,  he  is  thrice  dipped  into  the  lake, 
and  the  same  operation  is  repeated  every  day  for 
some  weeks."  Dr.  Mitchell,  Commissioner  of  Lunacy 
in  Scotland,  in  giving  an  account  of.  this  island  in 
1862,  says :  "  About  seven  years  before  (that  is, 
about  1855),  a  furious  madman  was  brought  there. 
A  rope  was  passed  round  his  waist,  and  with  a  couple 
of  men  at  one  end  in  advance,  and  a  couple  at  the 


34  TWENTY-FIVE    YEARS 

other  behind,  like  a  furious  bull  to  the  slaughter- 
house, he  was  marched  to  the  Loch  side  and  placed 
in  a  boat,  which  was  pulled  once  round  the  island,  the 
patient  being  jerked  into  the  water  at  intervals.  He 
was  then  landed,  drank  of  the  water,  attached  his 
offering  to  the  tree,  and,  as  I  was  told,  in  a  state  of 
happy  tranquillity  went  home."  Performances  nearly 
as  absurd  and  incredible  as  these  are  reported,  on 
good  authority,  to  have  taken  place  at  some  of  the 
Lochs  of  Scotland  within  fifteen  years. 

Ireland  can  claim  to  rival  its  sister  kingdom  in  the 
abundance  and  efficacy  of  its  sacred  waters.  In  Kerry 
is  a  glen  known  as  the  "Yalley  of  the  Lunatics,"  in 
which  are  two  wells  called  the  "Lunatics'  Wells." 
It  was  an  old  tradition,  very  generally  received  by 
the  common  people,  that  all  the  insane  in  the  coun- 
try, if  left  to  themselves,  would  find  their  way  to  this 
valley,  and  that  the  waters  and  other  mysterious  vir- 
tues of  the  glen  would  restore  them  to  mental  sound- 
ness. The  continental  countries  of  Europe  are  probably 
not  surpassed  by  Great  Britain  in  the  number  and 
character  of  their  popular  traditions  and  superstitions 
relating  to  the  relief  of  mental  maladies,  and  the 
treatment  appropriate  to  the  insane. 

Everything  among  us  is  comparatively  new.  We 
have  few  lakes,  wells,  or  valleys  around  which  tradi- 
tions have  been  able  to  gather.  Besides,  the  reaction 
following  the  witchcraft  excitement  introduced  an  era 
of  doubt  and  caution.  Yet  superstitious  notions  and 


WITH  THE   INSANE.  35 

observances,  of  a  somewhat  milder  and  less  offensive 
character,  touching  the  causes  and  treatment  of  insan- 
ity, might  easily  be  gathered  up,  which  would  con- 
siderably lessen  our  native  inclination  to  compare 
ourselves  with  the  older  nations  to  their  disadvantage. 
Reference  has  already  been  made  to  remedies 
anciently  employed  by  physicians  of  education  and 
intelligence.  This  point  will  bear  a  little  additional 
illustration,  which  will  render  the  progress  of  recent 
years  more  obvious.  In  1542,  a  London  physician, 
one.  Dr.  Borde,  published  a  medical  work,  in  which 
he  says,  "  I  do  advertise  every  man  the  which  is  mad, 
or  lunatic,  or  frantic,  or  demoniac,  to  be  kept  in  safe- 
guard in  some  close  house  or  chamber  where  there  is 
little  light ;  and  that  he  have  a  keeper  the  which  the 
mad  man  do  fear."  He  further  directs  that  no  pic- 
tures of  man  or  woman  be  placed  upon  the  walls  of 
the  room,  and  that  the  patient  be  not  allowed  to  have 
any  instrument  with  which  he  could  do  himself 
harm.  He  is  to  be  shaved  once  a  month,  to  drink 
no  strong  liquor,  and  to  be  provided  with  a  simple 
diet.  This  doctor  was  evidently  much  in  advance  of 
his  age  in  his  ideas  and  methods.  Allusions  in  liter- 
ature indicate  a  generally  received  opinion  that  the 
insane  should  be  confined  in  darkened  rooms.  In 
"  Twelfth  Night,"  Shakespeare  makes  one  of  his  actors 
say,  "Come,  we'll  put  him  in  a  dark  room,  and 
bound.  My  niece  is  already  in  the  belief  that  he  is 
mad."  And  in  "As  You  Like  It,"  another  says, 


36  TWENTY-FIVE   YEARS 

"  Love  is  merely  a  madness ;  and,  I  tell  you,  deserves 
as  well  a  dark  house  and  a  whip,  as  madmen  do." 

The  medical  treatment  prescribed  in  Burton's 
famous  work,  "  The  Anatomy  of  Melancholy,"  con- 
sists mainly  in  the  use  of  herbs,  some  to  affect  the 
heart,  some  the  head,  some  the  liver,  some  the  stom- 
ach, and  others  to  purify  the  blood.  Hellebore  is  a 
favorite  remedy,  as  it  was  among  the  old  Romans. 

Another  author  recommends  for  epilepsy  and 
lethargy,  poultices  of  figs  and  mustard  applied  to  the 
head.  Feverfew  was  said  to  be  "  good  for  such  as  be 
melancholy,  sad,  pensive,  and  without  speech." 
Bachelors'  buttons  were  prescribed  to  be  "  hung  in  a 
linen  cloth  about  the  neck  of  him  that  is  lunatic,  in 
the  wane  of  the  moon,  when  the  sign  shall  be  in  the 
first  degree  of  Taurus  or  Scorpio." 

An  intimate  connection  was  believed  to  exist 
between  the  liver  and  insanity,  and  hence  it  was  of 
much  importance  "  to  get  rid  of  the  black  bile."  For 
this  purpose  purges,  emetics,  bleeding,  issues,  and 
shaving  the  head  were  advised.  "  A  choice  balsam 
of  earth-worms  or  bats"  was  recommended  for  anoint- 
ing the  backbone. 

The  belief  in  witchcraft  as  one  of  the  most  common 
and  virulent  causes  of  insanity  colored  the  medical  as 
well  as  the  legal  practice  of  many  centuries.  Burton 
recognized  this  as  active  in  producing  melancholy. 
Coke  and  Hale  recognized  it  in  the  conclusions  and 
decisions  of  the  courts  of  law.  King  James  I.  was 


WITH  THE   INSANE.  37 

violently  angry  with  Eeginald  Scot  for  daring  to 
oppose '  the  prevalent  belief,  and  for  affirming  that 
proper  medicines  and  wholesome  diet  were  more 
needed  than  tortures  and  punishments. 

The  treatment  thus  far  described  was  that  given 
outside  the  so-called  hospitals  and  asylums.  The 
practice  inside  these  institutions  was  scarcely,  if  at  all 
better,  even  late  in  the  eighteenth  century  and  in  the 
early  part  of  the  nineteenth.  An  English  practi- 
tioner, for  many  years  visiting  physician  to  one  of  the 
oldest  hospitals,  testified  before  the  Committee  of  the 
House  of  Commons  in  1815,  "  Patients  are  ordered 
to  be  bled  about  the  latter  end  of  May,  according  to 
ths  weather;  and  after  they  have  been  bled,  they 
take  vomits  once  a  week  for  a  certain  number  of 
weeks ;  after  that  we  purge  the  patients.  That  has 
been  the  practice  invariably  for  years  long  before  my 
time ;  it  was  handed  down  to  me  by  my  father,  and  I 
do  not  know  any  better  practice."  In  the  institution 
to  whose  inmates  these  enlightened  gentlemen  pre- 
scribed, there  were  five  "keepers,"  three  male  and  two 
female,  for  a  hundred  and  twenty -two  patients.  The 
kindly  efforts  of  the  physician  were  supplemented  by 
the  liberal  use  of  manacles  and  chains.  The  violent 
were  chained  about  the  legs,  the  arms,  the  wrists; 
chained  to  the  floor,  the  bed,  or  the  wall. 

One  has  well  said,  "It  is  difficult  to  understand 
why  and  how  they  continued  to  live  ;  why  their  care- 
takers did  not,  except  in  the  case  of  profitable 


38  TWENTY-FIVE   YEARS 

patients,  kill  them  outright;  and  why,  failing  this  — 
which  would  have  been  a  kindness  compared  with 
the  prolonged  torture  to  which  they  were  subjected  — 
death  did  not  come  sooner  to  their  relief." 


CHAPTER  VI. 

THE     BEGINNINGS     OF    REFORM    AND    IMPROVEMENT. 

Humanity  changes  for  the  better  slowly,  and  usually 
under  some  sort  of  compulsion.  The  compulsion  may 
be  from  within,  the  power  of  ideas ;  or  it  may  be  from 
without,  the  rougher  stimulus  of  muscular  force  and 
violence.  Customs  and  habits  are  ruts,  out  of  which 
institutions,  societies,  communities,  and  governments 
liave  to  be  pulled  or  lifted.  The  process  is  generally 
unpleasant,  often  painful,  sometimes  apparently  destruc- 
tive. Some  objects,  old  and  venerated,  are  sure  to  be 
broken  in  pieces  and  trodden  into  the  mire;  some 
things  of  real  beauty  and  utility,  on  account  of  their 
relations  and  surroundings,  are  ruthlessly  destroyed. 
Men  who  have  wrought  well,  according  to  their  con- 
ceptions of  truth  and  duty,  are  rudely  thrust  aside  or 
visited  with  unmerited  abuse  and  insult  Many  inter- 
ests suffer  for  a  while,  and  society  is  unsettled  and  dis- 
turbed. The  new  paths  are  untrodden,  and  the  surface 
is  uneven.  Unexpected  obstacles  are  encountered; 
mistakes  and  blunders  are  made.  The  new  leaders, 
with  the  best  of  intentions,  are  frequently  more  abun- 


•       WITH  THE   INSANE.  39 

dantly  endowed  with  zeal  than  wisdom.  Conservatism 
naturally  laments,  protests,  and  predicts  all  manner  of 
direful  consequences.  Even  hopeful  and  sympathizing 
men,  of  timid  and  fearful  temperament,  are  overbur- 
dened with  doubts  and  anxieties. 

All  these  and  other  conditions  hedged  up  and  ob- 
structed proposed  reforms  and  improvements  in  the 
treatment  of  the  insane.  It  required  confidence  and 
courage,  bordering  on  rashness  and  presumption,  to 
take  the  first  steps.  It  would,  however,  be  a  gross 
libel  upon  human  nature  to  suppose  that  humane  and 
Christian  men  and  women  were,  or  could  be,  satisfied 
with  things  as  they  existed.  The  apathy  of  the  great 
body  of  the  people  is  explained  by  the  fact  that  very 
few  knew  how  bad  matters  really  were.  The  insane 
could  not  speak  for  themselves,  and  nobody  had  yet 
come  forward  to  speak  and  act  for  them.  Somebody 
must  be  found  who  dared  to  begin,  and  who  had 
patience  "to  labor  and  to  wait"  Success,  even  in  a 
most  righteous  cause,  is  not  secured  in  a  moment,  nor 
without  a  struggle.  It  took  years  to  rouse  the  public 
mind  to  a  comprehension  of  the  horrors  and  barbarism 
of  the  slave-trade ;  it  took  other  long  years  to  break 
down  the  iron  doors  of  the  filthy  dungeons  in  which 
"prisoners  for  debt"  were  hopelessly  immured.  The 
task  of  cleaning  out  the  reeking  cells  in  which  many  of 
the  insane  were  confined,  of  breaking  off  their  fetters 
and  chains,  of  bringing  them  out  into  the  pure  air  and 
bright  sunlight,  and  securing  for  them  rational  and 


40  TWENTY-FIVE   YEARS    • 

scientific  treatment,  was  not  to  be  accomplished  in  a 
day,  nor  by  weak  and  intermittent  efforts.  Old  preju- 
dices were  exceedingly  strong,  and  medieval  ideas 
about  insanity  still  lingered  in  many  places,  both  low 
and  high.  Slaves  were  men;  debtors  were  fellow- 
citizens  ;  but  the  insane  were  not  even  yet  quite  free 
from  the  suspicion  of  evil  associations.  They  were, 
undoubtedly,  unfortunate  and  miserable ;  possibly  they 
might  also  be  wicked  and  blameworthy.  Such  feelings 
were  rather  felt  than  expressed ;  but  none  the  less  they 
influenced  conduct  and  conclusions. 

The  honor  of  instituting  and  leading  in  reform  and 
improvement  belongs  to  Pinel  in  France  and  to 
Tuke  in  England.  Each  of  these  men  labored,  for 
some  time,  apparently  with  little  or  no  knowledge  of 
the  purposes  and  efforts  of  the  other.  They  wrought 
with  different  means  and  under  widely  different  condi- 
tions ;  but  both  are  entitled  to  much  credit  and  to  grate- 
ful remembrance.  The  blessings  of  many  ready  to 
perish  have  rested  upon  them  and  upon  their  associates 
and  co-laborers. 

Pinel  was  a  thoroughly  educated  physician,  and, 
after  having  had  an  experience  of  a  few  years  in  a  pri- 
vate institution  for  the  insane,  was  put  in  charge  of  the 
Bicetre  in  Paris,  in  the  year  1792.  This  establishment 
was  at  the  same  time  a  prison,  almshouse,  nursery, 
hospital,  and  asylum  for  the  insane.  The  various 
classes  of  inmates  were  mingled  together  in  the  greatest 
confusion,  although  the  more  violent  maniacs  were 


WITH  THE   INSANE.  41 

confined  in  a  separate  quarter  of  the  buildings.  Cru- 
elty had  rendered  these  so  furious  that  few  persons 
ventured  to  approach  them,  and  no  one  dreamed  of 
freeing  them  from  their  chains. 

The  following  extract  will  show  the  character  of  the 
work  which  Pinel  undertook,  and  its  results.  Having 
obtained  permission  of  the  proper  authorities,  he  pro- 
posed to  try  the  experiment  of  liberating  some  of  those 
who  had  been  longest  in  confinement  Accompanied 
by  a  friend  he  entered  the  door  of  the  "  great  Bedlam 
of  France." 

"  They  were  received  by  a  confused  noise,  the  yells  and  angry 
vociferations  of  three  hundred  maniacs  mixing  their  sounds  with 
the  echo  of  clanking  chains  and  fetters  through  the  dark  and 
dreary  vaults  of  the  prison.  Couthon,  his  attendant,  turned 
away  with  horror,  but  permitted  the  physician  to  incur  the  risk 
of  his  undertaking.  He  began  by  unchaining  twelve  persons. 
The  first  was  an  English  officer  who  had  been  bound  in  his 
dungeon  forty  years,  and  whose  history  everybody  had  forgotten. 
His  keepers  approached  him  with  dread ;  he  had  killed  one  of 
his  comrades  by  a  blow  with  his  manacles.  Pinel  entered  his 
cell  unattended,  and  told  him  he  should  be  at  liberty  to  walk  at 
large,  on  condition  of  his  promising  to  put  on  the  camisole  or 
strait  waistcoat.  The  maniac  disbelieved  him,  but  obeyed  his 
directions  mechanically.  The  chains  of  the  miserable  prisoner 
were  removed,  the  door  of  his  cell  was  left  open.  Many  times 
he  was  seen  to  raise  himself  and  fall  backward, — his  limbs  gave 
way ;  they  had  been  fettered  during  forty  years.  At  length  he 
was  able  to  stand  and  to  walk  to  the  door  of  his  dark  cell.  He 
gazed  with  exclamations  of  wonder  and  delight  on  the  beautiful 
sky.  He  spent  the  day  in  walking  to  and  fro,  was  no  more  con- 
fined, and  during  the  remaining  two  years  he  spent  at  Bice*tre 
assisted  in  the  management  of  the  house. 


42  TWENTY-FIVE   YEARS 

"The  next  man  liberated  was  a  soldier  of  the  French  Guard, 
who  had  been  in  chains  ten  years,  and  was  an  object  of  general 
terror.  His  disorders  had  been  kept  up  by  cruelty  and  bad 
treatment.  When  liberated,  he  assisted  Pinel  in  breaking  the 
chains  of  his  fellow-prisoners;  he  became  kind  and  attentive 
immediately,  and  was  ever  after  the  devoted  friend  of  his  deliv- 
erer. In  a  few  days  Pinel  liberated  fifty-three.  The  result  was 
beyond  all  hope.  Tranquillity  and  harmony  succeeded  to  tumult 
and  disorder;  even  the  most  furious  maniacs  became  tractable." 

Subsequently  Pinel  took  charge  of  the  Salpetriere, 
a  similar  place  of  confinement  for  females,  into  which 
he  introduced  the  same  humane  principles  and  spirit  of 
reform.  The  improvement  in  the  condition  and  treat- 
ment of  the  insane  in  France  commenced  with  the 
beginning  of  Pinel's  labors  in  Paris.  He  was  ably 
seconded  in  his  efforts  by  Bsquirol,  who  became  his 
assistant  in  the  Salpetriere.  This  gentleman  founded 
an  asylum  for  the  insane  in  1799,  which  served  as  a 
model  for  all  similar  institutions  afterwards  established 
in  France.  Without  doubt  the  great  experiment  of 
Pinel  had  its  origin  in  the  feelings  and  impulses  of  a 
generous  humanity,  more  than  in  the  conclusions  of 
scientific  medical  knowledge,  although  subsequent  in- 
vestigations and  discoveries  have  proved  that  his 
methods  were  in  harmony  with  the  true  principles  of 
the  science  of  medicine  as  well  as  of  the  science  of 
mind.  In  the  hands  of  wise  men  science,  in  all  depart- 
ments of  human  activity,  is  the  handmaid  and  servant 
of  humanity. 

To  William  Tuke  of  York,  a  member  of  the  Society 
of  Friends,  belongs  the  high  honor  of  establishing  the 


WITH  THE   INSANE.  4£ 

first  asylum  for  the  insane  in  England  in  which  humane 
and  rational  methods  of  treatment  were  regularly  and 
systematically  employed.  He  commenced  his  efforts  in 
1792,  the  same  year  which  saw  the  beginnings  of  Pinel's 
public  labors  in  Paris.  The  institution  was  opened  for 
the  reception  of  patients  four  years  later.  The  happy 
suggestion  of  a  woman  gave  to  the  hospital  the  name 
of  Eetreat,  "  to  convey  the  idea  of  what  such  an  insti- 
tution should  be,  namely,  a  place  in  which  the  unhappy 
might  obtain  a  refuge,  a  quiet  haven  in  which  the 
shattered  bark  might  find  the  means  of  reparation  or  of 
safety."  It  was  located  on  elevated  ground  in  the 
neighborhood  of  York.  The  edifice  was  surrounded  by 
a  garden,  and  sufficient  land  was  secured  for  a  farm. 
The  prospect  was  pleasant  and  extensive,  and  pure  air 
and  excellent  water  were  abundant.  The  building  was 
unpretentious,  like  its  founder  and  like  the  society  to 
which  he  belonged.  For  several  years  Mr.  Tuke  per- 
sonally superintended  the  affairs  of  the  Retreat,  and 
continued  to  visit  it  frequently  till  his  death  at  an 
advanced  age. 

Like  most  departures  from  the  established  order  of 
things,  this  pioneer  reform  asylum  encountered  some 
bitter  opposition,  and  met  with  serious  obstacles  and 
difficulties.  Fortunately,  its  founder  possessed  the 
somewhat  rare  combination  of  a  determined,  iron  will 
closely  united  with  a  kind  heart  His  sympathy  had 
been  thoroughly  excited,  and  his  sensibilities  both 
shocked  and  quickened,  by  a  visit  to  a  hospital  in 


44  TWENTY-FIVE   YEARS 

which  he  found  inmates  lying  "on  straw  and  in  chains." 
He  had,  moreover,  that  peculiar  constitution  of  mind 
which  impelled  him  to  believe  that  whatever  ought  to 
be  and  needed  to  be  done,  could  be  accomplished  by 
perseverance  and  hard  work. 

The  nature  and  extent  of  the  reforms  in  the  treat- 
ment of  the  insane  begun  at  the  York  Ketreat  can  not 
be  fully  appreciated  by  persons  familiar  only  with  the 
appliances  and  methods  of  well-conducted  modern 
asylums.  The  management  of  Mr.  Tuke  and  his  asso- 
ciates must  be  contrasted,  by  means  of  examples  and 
illustrations,  with  the  prevailing  modes  of  that  day. 
It  is,  however,  profoundly  humiliating  to  be  obliged  to 
confess  that,  after  the  lapse  of  nearly  a  century,  con- 
trasts almost  as  striking  can  be  found  between  the 
treatment  endured  in  local  receptacles,  county  houses, 
and  jails,  and  that  employed  in  our  best  asylums.  The 
statement  of  a  gentleman  who  visited  at  that  period  a 
large  number  of  British  asylums,  for  the  purpose  of 
examining  plans  of  construction,  will  be  sufficient  to 
indicate,  in  a  general  way,  the  changes  and  improve- 
ments made  in  the  Eetreat  He  says : 

"  In  some  asylums  which  I  have  visited,  chains  were  affixed 
to  every  table  and  to  every  bedpost;  in  others  they  are  not  to  be 
found  within  the  walls.  At  the  Retreat  they  sometimes  have 
patients  brought  to  them  frantic  and  in  irons,  whom  they  at  once 
release  and  by  mild  arguments  and  gentle  arts  reduce  almost 
immediately  to  obedience  and  orderly  behavior.  A  great  deal  of 
delicacy  appears  in  the  attention  paid  to  the  smaller  feelings  of 
patients.  The  iron  bars  which  guarded  the  windows  have  been 


WITH  THE   INSANE.  45 

avoided,  and  neat  iron  sashes,  having  all  the  appearance  of 
wooden  ones,  have  been  substituted  in  their  places ;  and  when  I 
visited  them,  the  managers  were  occupied  in  contriving  how  to 
get  rid  of  the  bolts  with  which  the  patients  were  shut  up  at  night, 
on  account  of  their  harsh,  ungrateful  sound,  and  of  their  com- 
municating to  the  asylum  somewhat  of  the  air  and  character  of 
a  prison.  The  effects  of  such  attention,  both  on  the  happiness  of 
the  patients  and  the  discipline  of  the  institution,  are  more  impor- 
tant than  may  at  first  view  be  imagined.  Attachment  to  the 
place  and  to  the  managers,  and  an  air  of  comfort  and  content- 
ment, rarely  exhibited  within  the  precincts  of  such  establishments, 
are  consequences  easily  discovered  in  the  general  demeanor  of  the 
patients.  It  is  a  government  of  humanity  and  of  consummate 
skill,  and  requires  no  aid  from  the  arm  of  violence  and  the  exer- 
tions of  brutal  force." 

Under  this  treatment  a  man  who  had  been  kept 
chained  and  naked  for  twenty  years,  soon  came  to  wear 
clothes  and  to  be  orderly  in  his  habits  and  conduct. 
The  change  in  many  others  was  as  marked  and  as 
happy. 

In  addition  to  the  points  already  mentioned,  efforts 
were  made  to  provide  constant  employment  for  those 
inmates  who  were  able  to  work.  The  convalescents 
were  employed  as  assistants  in  the  care  of  others; 
knitting,  sewing,  and  other  domestic  labors  were 
assigned  to  female  patients ;  and  the  men  were  occupied 
with  such  industries  as  would  be  most  agreeable,  as  far 
as  means  and  circumstances  would  allow. 

This  experiment  at  York  and  a  "  Description  of  the 
Eetreat,"  published  by  Samuel  Tuke  in  1813,  aroused 
much  public  interest  in  England,  and  excited  some 
vigorous  and  angry  discussions.  Periodicals  and  news- 


46  TWENTY-FIVE   YEARS 

papers  entered  into  the  details.  The  House  of  Com- 
mons appointed  committees  and  commissions  to  inquire 
into  the  condition  of  asylums  and  hospitals  for  the 
insane.  Acts  of  Parliament  were  passed ;  new  insti- 
tutions were  established,  and  old  ones  were  forced  to 
recognize  the  progress  of  the  age  and  the  claims  of 
humanity. 

Reform  and  improvement  were  thoroughly  inaugu- 
rated, and  the  condition  of  the  insane  began  to  be 
rendered  more  tolerable.  Great  advances  have  since 
been  made,  but  it  is  not  to  .be  supposed  that  the  end 
has  even  yet  been  reached.  Progress  is  still  possible. 

At  the  time  when  Pinel  and  Tuke  commenced  their 
reformatory  labors  in  Europe,  only  a  single  asylum 
existed  in  the  United  States  devoted  exclusively  to  the 
insane.  A  few  insane  patients  were  admitted  into  two 
or  three  general  hospitals.  Of  these  two  or  three,  the 
Pennsylvania  Hospital  was  the  most  prominent  and 
important  As  has  been  elsewhere  remarked,  it  is 
claimed  that  the  improved  and  humane  methods  of  the 
reformers  were  employed  in  this  institution  from  the 
very  first.  The  probabilities  are  that  the  claim  is  well 
founded.  Kefonn  in  our  own  country  was  needed, 
not  so  much  in  correcting  the  bad  management  of 
existing  institutions  as  in  creating  a  public  sentiment 
which  should  demand  the  erection,  at  public  expense, 
of  a  sufficient  number  of  asylums  to  receive  and  prop- 
erly care  for  the  victims  of  insanity  who  were  wander- 
ing at  large,  or  were  cowering  in  filth  and  nakedness  in 


WITH   THE   INSANE.  47 

jails  and  in  rude  out-buildings,  in  receptacles  of  all 
kinds.  The  abuse  and  neglect  of  the  insane  among 
us  have  never  been,  to  any  considerable  extent,  within 
the  hospitals.  Rare  and  infrequent  instances  have 
occurred  in  these  institutions,  without  doubt ;  but  such 
cases  bear  no  comparison  to  those  which  have  taken 
place,  almost  daily,  in  almshouses  and  other  places  of 
detention,  and,  with  shame  it  must  be  said,  in  the  seclu- 
sion of  private  and  domestic  life. 


CHAPTER  VII. 
THE   MODERN   ASYLUM. 

Of  any  specific  form  and  arrangement  of  buildings 
for  an  asylum  I  shall  not  presume  to  speak.  Only  a 
specialist  of  intelligence  and  experience  can  determine, 
with  any  authority,  matters  of  that  kind.  My  remarks 
will  have  reference  merely  to  such  things  as  an  inter- 
ested observer,  under  favorable  conditions,  can  readily 
discover  and  appreciate. 

First  of  all,  it  will  be  universally  conceded  that  the 
location  of  an  institution  for  the  insane  should  be 
healthful  and  pleasant.  The  grounds  should  be  ample 
in  extent  and,  if  possible,  varied  in  character.  The 
wearisome  monotony  of  a  dead  level  of  surface  or  of 
entire  sameness  of  scenery  should  be  avoided.  An 
abundant  supply  of  pure  water  must  be  near  at  hand, 
and  the  facilities  for  drainage  and  for  the  removal  of 


48  TWENTY-FIVE   YEARS 

all  filth  must  be  excellent  The  site  should  be  suffi- 
ciently retired  to  secure  freedom  from  noise  and  con- 
fusion and  from  undue  observation.  At  the  same  time 
it  should  be  easy  of  access,  both  for  the  convenience  of 
patients  and  their  friends,  and  also  for  the  ready  trans- 
portation of  material  and  supplies.  A  farm  of  two  or 
three  hundred  acres  of  rolling  land,  with  a  fertile  soil,. 
not  too  clayey,  with  a  fair  proportion  of  groves  and 
woodland,  just  on  the  outskirts  of  some  city  or  village 
of  considerable  size,  will  best  satisfy  the  requirements 
as  to  location. 

The  buildings  should  be,  of  course,  substantial  and 
durable  in  character,  but  the  style  of  architecture 
should  be  light  and  tasteful.  Care  should  be  taken  to 
avoid  all  prison -like  appearance.  Excessive  ornament- 
ation adds  nothing  in  respect  of  beauty,  and  is  incon- 
gruous as  a  matter  of  good  taste.  Local  pride  takes 
an  unfortunate  direction  when  it  demands  unnecessary 
expenditure  upon  the  external  means  and  appliances 
of  public  charity  and  benevolence. 

The  interior  arrangements  ought  to  provide,  in  the 
best  possible  manner,  for  the  care,  comfort,  and  safety 
of  the  inmates.  Danger  from  fire  should  be  especially 
guarded  against  The  horror  of  a  burning  asylum  for 
the  insane  can  be  equaled  only  by  that  of  a  burning 
receptacle  of  helpless  orphan  children.  Humanity 
shudders  at  the  sight,  or  even  the  thought,  of  either. 
Buildings  of  many  stories  in  height,  with  narrow  doors 


WITH   THE    INSANE.  49 

and  steep  and  winding  stairways,  are  unsuitable  for 
asylums  and  hospitals. 

Judicious  classification  of  patients  is  one  of  the  im- 
perative necessities  for  the  proper  treatment  of  mental 
disease.  This  must  be  fully  provided  for,  or  the  main 
purpose  for  which  asylums  exist  will  be  defeated.  On 
many  accounts,  the  gathering  of  large  numbers  of  the 
insane  in  one  institution  is  not  desirable.  The  possi- 
bility of  more  complete  classification,  however,  is  in- 
creased by  this  arrangement;  and  the  advantages 
derived  from  the  separation  of  those  whose  peculiar 
mental  condition  renders  them  unfit  associates,  will 
probably  offset  many  real  disadvantages.  The  abso- 
lute impossibility  of  making  any  tolerable  classification 
of  their  inmates  is  a  fatal  objection  to  county  and  other 
small  receptacles,'  into  which  all  forms  of  mental  dis- 
order are  crowded  promiscuously  together. 

An  experienced  Medical  Superintendent  says,  "  Every 
asylum  should  have  separate  accommodations  for  the 
following  classes  of  patients:  1.  Those  convalescing 
from  various  forms  of  mental  disease.  2.  Those  suf- 
fering from  mild  excitement  3.  Those  suffering  from 
acute  excitement  4.  Those  suffering  from  epilepsy 
and  the  advanced  stages  of  paresis.  5.  Those  suffer- 
ing from  chronic  mania  6.  Those  suffering  from 
melancholia  and  states  of  depression.  7.  Those  suf- 
fering from  senile  and  other  quiet  forms  of  dementia. 
8.  Those  suffering  from  the  more  active  forms  of  de- 
mentia (irritable  dementia)."  , 


50  TWENTY-FIVE   YEARS 

One  of  the  most  characteristic  features  of  the  mod- 
ern, improved  asylum  is  this  perfect  separation  of  the 
various  classes  of  patients.  The  lack  of  it  has  been 
very  painfully  impressed  upon  me  in  visiting  several 
county  receptacles  for  insane  paupers.  A  strong  and 
violent  female,  gesticulating  and  shouting  under  the 
influence  of  maniacal  excitement,  may  be  seen  near  by 
a  weak  and  timid  old  lady  suffering  from  senile  de- 
mentia. And  in  the  same  apartment  may  be  an  epi- 
leptic in  the  midst  of  a  terrible  and  frightful  convul- 
sion. All  the  better  feelings  of  humanity  revolt  at 
the  pain  inflicted  by  this  promiscuous  herding  together 
of  the  unfortunate  and  distressed. 

In  addition  to  provision  for  proper  classification,  the 
model  asylum  will  have  all  its  rooms,  which  patients 
are  to  occupy,  well-lighted,  warmed,  and  ventilated. 
It  ought  to  be  unnecessary  to  say  that  no  "  cells,"  or 
apartments  of  cell-like  character,  exist  in  any  really 
modern  .institution  for  the  insane.  Such  prison -like 
arrangements  belonged  to  the  age  of  "chains  and  fet- 
ters," the  iron  age  which  preceded  the  reforms  of  Pinel 
and  Tuke.  If  any  so-called  asylum  still  tolerates  and 
finds  use  for  them,  its  managers  should  speedily  give 
place  to  others,  whose  birth  and  education  have  been 
within  the  present  century. 

The  halls  and  all  the  rooms  will  be  made  as  cheerful 
as  possible  by  inexpensive  ornamentation.  If  encour- 
aged, many  of  the  inmates  will  take  an  active  interest 
in  rendering  everything  as  home-like  as  circumstances 


WITH   THE   INSANE.  51 

will  permit  The  floors  will  be  painted  or  oiled,  and 
in  some  cases  carpeted.  The  walls  will  be  pleasantly 
tinted,  and  hung  with  paintings  and  pictures.  The 
halls  occupied  by  convalescent  and  other  quiet  and 
orderly  patients  will  be  supplied  with  musical  instru- 
ments, with  papers,  periodicals,  and  books.  Conven- 
iences for  games  and  sports  will  be  provided,  both 
within  doors  and  on  the  grounds.  Amusements  and 
recreations  of  a  social  character  will  be  frequent,  and 
will  be  open  to  all  whose  condition  will  allow  them  to 
participate,  or  to  enjoy  relaxation  in  this  way.  Officers, 
physicians,  and  attendants  all  unite  to  give  to  a  life, 
which  at  best  must  have  much  of  monotony,  as  much 
variety  and  cheerfulness  as  the  circumstances  and  sur- 
roundings will  permit 

I  am  not  trying  to  paint  an  ideal  institution,  man- 
aged by  ideal  officers  and  peopled  by  an  ideal  class  of 
inmates.  I  am  only  speaking  of  what  I  have  observed, 
and  of  what  is  practicable  in  any  institution  where 
there  is  a  hearty,  earnest  purpose  to  do  all  that  can  be 
done  to  comfort  and  to  cure. 

No  asylum  or  hospital  can  be  made  a  home  in  the 
highest  and  best  sense  of  that  word ;  but  it  can  be 
made  to  resemble  a  real  home,  and  to  surpass  almost 
infinitely  scores  and  hundreds  that  are  called  by  that 
name.  If  there  were  more  true  homes  inhabited  and 
animated  by  the  spirit  of  tenderness,  forbearance,  and 
mutual  helpfulness,  fewer  asylums  would  be  required, 
and  the  existing  ones  would  be  less  crowded. 


52  TWENTY-FIVE  YEARS 

By  means  of  detached  cottages  and  other  devices,  it 
will  undoubtedly  be  found  possible  to  add,  in  many 
respects,  to  the  home-like  character  of  institutions  for 
the  insane,  and  also  of  institutions  for  other  classes  of 
the  unfortunate  and  dependent  In  public  schools  for 
neglected  and  dependent  children,  and  in  reformatories, 
this  is  already  attempted  with  a  fair  degree  of  success. 
Beyond  certain  limits,  however,  this  is  not  desirable. 
Life  in  a  public  institution,  of  whatever  form  and  how- 
ever organized,  is  not  like,  and  can  not  be  like,  real  out- 
of-door,  every-day  life.  To  the  child  or  the  youth,  it 
is  not  the  best  preparation  for  the  actual  life  into  which 
he  must  presently  enter.  The  aim  should  be  to  keep 
the  child,  or  the  adult  even,  unless  it  be  for  crime,  in 
the  institution  the  shortest  possible  time.  There  is 
less  danger  of  fostering  unreal  notions  of  ordinary  life 
in  an  asylum  for  the  insane  than  in  most  other  public 
institutions ;  but  its  arrangements  should  not  be  such 
as  to  create  distaste  for  the  kind  of  life  to  which  the 
patient  must  return,  or  to  present  too  strong  tempta- 
tions for  prolonging  his  residence  in  the  institution. 
It  is  due  to  truth  to  add  that  danger  in  this  direction 
can  not  become  of  a  serious  nature  under  any  conditions 
at  present  conceivable. 

The  modern  asylum,  I  am  persuaded,  will  continue 
to  put  forth  more  and  more  effort  to  provide  suitable 
employment  for  its  patients  who  are  able  to  labor. 
This  will  not  be  attempted  for  economic  reasons.  It  is 
not  probable  that  the  labor  of  the  insane  can  be  made 


WITH  THE   INSANE.  53 

a  source  of  profit  to  the  institution.  For  the  present, 
at  least,  it  is  more  likely  to  cause  an  increase  of  ex- 
penditure. Employment  will  be  provided  for  the 
same  reasons  that  books  and  music,  amusements  and 
recreations  are  provided,  as  a  curative  agency.  En- 
forced idleness  is  not  merely  irksome  to  men  and 
women  in  early  or  middle  life  and  of  fair  physical 
health  and  vigor,  who  have  been  accustomed  to  an 
active  and  laborious  manner  of  living,  but  is  a  posi- 
tive source  of  danger,  more  especially  when  the 
mental  balance  has  been  lost.  Industrial  pursuits  of 
some  sort  are  needed  to  give  an  outlet  for  energy 
which  will  otherwise  be  consumed  in  acts  of  destruc- 
tion and  violence,  or  will  find  vent  in  maniacal  ex- 
citement and  disorder.  Without  doubt,  such  occu- 
pations will  enable  the  managers  of  asylums  to 
dispense  almost  entirely  with  all  forms  of  mechanical 
or  medical  restraints.  It  will  be  readily  conceded 
that  many  difficulties  must  be  encountered  in  pro- 
viding employment  for  all  classes  of  the  insane. 
Indeed,  I  do  not  conceive  it  possible  to  do  so  with 
any  means  now  at  the  command  of  the  officers  in 
charge  of  existing  institutions.  I  am  confident,  how- 
ever, that  the  near  future  will  see  great  improvement 
in  this  direction. 

Some  other  important  characteristics  of  modern 
asylums  will  be  touched  upon,  directly  or  incident- 
ally, in  subsequent  chapters. 


54  TWENTY-FIVE   YEARS 


CHAPTER  VIII. 

GUARANTIES   FOR  THE   SAFETY   AND   PROPER  CARE   OF 
THE   INSANE   IN  ASYLUMS. 

Many  of  the  insane  are  utterly  helpless  and  de- 
fenseless. The  infant  in  the  cradle  is  not  more  so. 
Their  mental  condition  is  such  that  they  can  neither 
comprehend  nor  make  known  to  others  their  wants ; 
and  their  physical  state  is  such  that,  if  left  to  them- 
selves, they  would  soon  perish  or  become  repulsive 
and  loathsome.  Patients  of  this  class  are  entirely 
dependent  upon  their  attendants  for  cleanliness,  for 
food,  and  for  clothing,  while,  in  not  a  few  cases,  they 
are  unable  to  appreciate  kindness  or  to  express  grati- 
tude. Even  near  relatives  and  personal  friends  find 
it  not  easy  to  escape  the  charge  of  neglect  in  caring 
for  such  pitiable  victims  of  disease. 

Other  classes  of  the  insane,  not  so  weak  in  body  or 
mind,  are  nearly  as  defenseless  and  dependent  as 
these.  In  consequence  of  the  delusions  under  which 
they  are  suffering,  or  for  other  obvious  reasons,  little 
reliance  can  be  put  in  what  they  say.  Their  stories 
of  the  treatment  received  by  them  at  home  are  too 
improbable,  and  often  monstrous,  to  admit  of  belief 
even  for  a  moment.  The  same  inability  to  distin- 
guish delusions  from  realities  characterizes  their 
statements  concerning  affairs  connected  with  the 


WITH  THE   INSANE.  55 

asylum.  I  have  myself  listened  to  recitals  which,  if 
true,  would  curdle  the  blood  and  kindle  hot  indigna- 
tion. It  required,  however,  very  little  discernment 
to  enable  one  to  see  that  the  things  stated  could  not, 
by  any  possibility,  have  occurred.  The  result  is  that 
suspicion  and  doubt  are  thrown  over  all  statements 
of  the  insane,  and  of  those  who  have  fallen  into  any 
form  of  mental  unsoundness.  Consequently  reports 
of  neglect  or  abuse  coming  from  patients,  even  though 
well  founded,  will  have  little  weight  unless  corrobo- 
rated by  other  testimony.  However  much  to  be 
regretted,  this  is  inevitable.  In  the  great  majority 
of  cases  no  injustice  will  be  done ;  but  occasionally, 
under  these  circumstances,  a  genuine  and  truthful 
charge  of  wrong-doing  will  be  discredited.  No  can- 
did observer,  with  ordinary  knowledge  of  human 
nature,  will  be  disposed  to  deny  this  possibility. 
Where  escape  from  detection  is  easy,  or  even  seems 
so,  the  power  of  temptation  is  greatly  increased. 
Experience  teaches  that  bad  and  heartless  men  and 
women,  in  every  relation  of  life,  take  advantage  of 
this  state  of  affairs.  The  family  affords  illustrations 
of  this  as  frequently  as  the  asylum  or  the  hospital. 
The  way  by  which  danger  from  this  source  can  be 
entirely  avoided  has  not  yet  been  discovered.  The 
practical  problem  is  how  to  reduce  it  to  the  minimum. 
Still  another  fact  increases  the  helplessness  and 
dependence  of  one  class  of  patients.  The  probabil- 
ity of  restoration  from  certain  forms  of  mental  disease 


56  TWENTY-FIVE   YEARS 

is  undoubtedly  much  greater  if  the  patient  can  be 
completely  secluded,  for  a  time,  from  all  association 
with  relatives  and  intimate  friends.  The  chances  of 
recovery  may  be  increased  many  times  over  to  the 
wife  and  mother,  by  separation  for  weeks,  perhaps 
for  months,  from  every  familiar  scene  and  face,  from 
husband  and  children  and  life-long  friends.  The 
same  may  be  true  of  a  father  and  husband,  of  a  son 
or  a  daughter.  The  necessity  and  advantage  of  such 
entire  seclusion  will  naturally  be  denied  by  some, 
and  probably  questioned  by  very  many.  It  seems 
heartless  and  positively  cruel.  Observation,  how- 
ever, has  left  no  doubt  in  my  own  mind  that  such  a 
course  is  sometimes  the  only  one  which  affords  good 
grounds  for  hope  of  ultimate  restoration  to  mental 
health.  The  condition  is  peculiarly  sad  and  trying 
for  the  patient  and  distressing  for  the  friends.  /It 
imposes,  also,  peculiar  responsibility  upon  the  officers 
of  an  asylum.  It  is  inconceivable  that  any  officer, 
possessed  of  the  ordinary  feelings  of  humanity, 
would  recommend  or  advise  such  separation,  unless 
he  deemed  it  an  absolute  necessity  to  successful 
treatment.  Such  cases,  not  unfrequently.  open  the 
flood-gates  of  criticism  and  abuse.  Out  of  these 
have  grown  most  of  the  harrowing  tales  concerning 
the  horrors  of  asylum  life.  It  will  be  freely  admitted 
that  patients  of  this  class  are,  for  the  time,  placed 
without  reserve  in  the  hands  of  those  in  charge  of  the 
institution.  In  accepting  such  trusts,  obligations  are 


WITH  THE   INSANE.  5.7 

entered  into  which  a  good  man  would  gladly  avoid, 
and  which  a  bad  man  may  violate. 

It  would  be  easy  to  multiply  illustrations  of  the 
helpless  and  defenseless  condition  of  a  very  large  pro- 
portion of  the  inmates  of  any  institution  for  the 
insane.  It  would  also  be  easy  to  show  that  the  con- 
dition of  the  insane  outside  of  asylums  is,  in  a  major- 
ity of  cases,  still  more  helpless  and  defenseless.  This 
ought  always  to  be  kept  in  mind  in  considering  the 
subject  under  discussion.  Mental  disease,  when  ser- 
ious in  its  character,  exposes  the  sufferer  to  neglect, 
or  injustice,  or  abuse,  at  all  times  and  in  all  places,  in 
the  family,  in  the  community,  in  the  court-room,  and 
in  the  hospital.  Wisdom  and  humanity  demand  that 
all  known  precautions  shall  be  taken  to  secure  pro- 
tection and  safety. 

I  have  purposely  written  with  plainness.  With 
human  nature  as  it  is,  there  is  everywhere  danger  to 
the  weak  and  helpless.  It  were  worse  than  folly  to 
deny  its  existence  in  asylums.  The  question  is  how 
to  guard  against  it  most  effectively.  Upon  this 
question  I  desire  to  speak  with  the  utmost  frankness, 
because  I  believe  it  concerns  the  well-being  of  the 
most  unfortunate  class  of  sufferers  in  human  society, 
and  also  because  I  believe  the  means  employed  to 
avert  danger  often  increase  it,  and  the  measures 
adopted  to  secure  safety  render  the  attainment  of  this 
next  to  impossible. 


58  TWENTY-FIVE   YEARS 

The  public  mind  is  justly  sensitive  in  respect  to 
the  management  of  all  public  institutions.  But  any 
institution  whose  doors  can  not  all  be  thrown  open 
freely  to  promiscuous  visitation  and  inspection,  about 
which  there  is  something  of  reserve  and  exclusive- 
ness,  is  in  danger  of  exciting  feelings  of  jealousy  and 
distrust  in  the  ignorant  and  credulous,  and  even  in 
those  who  resent  the  imputation  of  ignorance  or 
credulity.  Asylums  for  the  insane  necessarily  belong 
to  this  class  of  institutions.  Grant,  what  is  often 
asserted,  that  the  system  of  reserve  and  exclusion  has 
sometimes  been  carried  to  an  unnecessary  extreme ; 
grant  that  doors  have  been  kept  closed  which  might 
more  wisely  have  been  left  open ;  after  all  possible 
admissions,  it  remains  evident  to  any  person  of 
common  intelligence  that  the  halls  of  such  an  institu- 
tion can  not  be  exposed  unreservedly  to  the  public 
gaze. 

As  a  result  of  this  necessary  exclusion  and  of  other 
causes,  against  which  no  wisdom  or  prudence  can 
effectually  guard,  periodical  outbursts  of  popular 
feeling  against  asylums  and  their  management  are 
liable  to  occur.  Violent  abuse  is  heaped  upon  trus- 
tees, superintendents,  officers,  and  employees  gener- 
ally. Newspapers  are  filled  with  stories  of  the  most 
fearful  and  terrible  nature.  Eeports,  gathered  from 
all  sources,  are  eagerly  received  and  accepted  as 
reliable  evidence  of  shocking  neglects  and  abuses. 
Upon  such  testimony  men  and  women  of  the  noblest 


WITH  THE   INSANE.  59 

character  and  purest  lives  are  condemned  and  de- 
nounced as  monsters  of  iniquity  and  cruelty.  Legis- 
lative and  other  investigations  follow,  and  elaborate 
reports  are  made  and  published.  Some  new  laws  are 
enacted,  and  additional  provisions  are  made  for  visit- 
ing and  examining  boards  and  commissions. 

It  would  be  too  much,  probably,  to  affirm  that  no 
good  results  come  from  such  excitements  and  investi- 
gations. But  it  is  beyond  question  that,  in  most 
cases,  the  evil  results  greatly  outweigh  the  good. 
Some  bad  men  may  be  exposed,  removed,  and  pun- 
ished. Some  abuses  may  be  corrected.  But  the 
work  of  the  institution  has  been  thrown  into  con- 
fusion; the  inmates  have  been  stirred  into  feverish 
excitement;  friends  of  patients  have  been  alarmed 
and  pained ;  and  the  community  has  been  filled  with 
false  or  exaggerated  statements,  calculated  to  create  a 
lasting  feeling  of  suspicion  and  distrust.  And,  worst 
of  all,  the  men  and  women  best  qualified  by  nature 
and  acquirements  to  care  for  the  insane  quietly  retire, 
or  decline  to  enter  positions  where  they  will  be  ex- 
posed to  unmerited  detraction  and  abuse. 

It  is  not  by  such  methods  that  safety  and  proper 
care  can  be  secured  for  the  insane.  Various  means 
have  been  devised,  and  others  have  been  suggested 
and  zealously  advocated.  Among  such  means  are 
laws,  and  rules  and  regulations  for  the  organization  of 
asylums,  for  the  admission  of  patients,  and  for  their 
proper  care,  oversight,  and  discharge.  Laws  for 


60  TWENTY-FIVE   YEARS 

these  purposes  are  absolutely  necessary,  and  without 
doubt  afford  some  measure  of  protection  to  certain 
classes  of  the  insane,  and  particularly  to  persons  who 
may,  for  sinister  purposes,  be  accused  of  mental 
unsoundriess.  But  legislative  enactments,  however 
wisely  drawn,  can  give  little  guaranty  for  right  treat- 
ment of  patients  within  the  halls  of  an  institution. 
They  are  not,  like  the  laws  of  nature,  endowed  with 
a  self-enforcing  vitality  and  virtue.  To  a  consider- 
able extent,  they  must  be  executed  by  those  whose 
conduct  they  are  designed  to  control  and  regulate. 

Boards  of  control,  commissioners,  and  visitors  are 
also  accounted  among  the  agencies  of  safety  and  pro- 
tection. Some  of  these  are  necessary,  and  others 
may  be  desirable.  There  must  be  some  organizing 
and  managing  body,  some  power  to  appoint  and  dis- 
charge officers  and  employees,  to  exercise  oversight, 
and  to  administer  generally  the  financial  and  other 
affairs  of  an  institution.  A  competent  board,  intelli- 
gent in  the  direction  of  its  trust,  free  from  partisan 
and  political  influence  and  dictation,  above  self-seek- 
ing, and  not  afraid  of  incurring  temporary  popular 
displeasure,  will  be  a  source  of  confidence  to  the  pub- 
lic, and  a  guaranty  of  wise  external  administration 
and  of  a  careful  selection  of  officers  to  perform  the 
delicate  and  varied  duties  of  internal  management. 
Men  of  business,  practitioners  of  law  and  medicine, 
students  of  the  science  of  mind,  and  practical  phi- 
lanthropists, may  well  be  united  in  the  formation  of 


WITH  THE   INSANE.  61 

such  a  board.  In  a  general  way  this  body  stands 
between  the  community  and  the  officers  and  inmates 
of  the  asylum.  It  is  a  standing  and  perpetual  "  com- 
mittee of  examination  and  investigation."  It  should 
be  better  able  than  any  other  number  of  persons  pos- 
sibly can  be,  to  protect  the  innocent  and  to  discover 
and  punish  the  guilty,  if  there  be  any  guilty. 

Other  agencies,  supposed  to  be  protective,  might  be 
mentioned,  but  observation  has  led  me  to  consider 
them  of  little  real  worth.  There  is,  in  my  judgment, 
but  one  guaranty  upon  which  any  firm  reliance  can 
be  placed,  and  that  is  the  character  and  intelligence  of 
the  officers  in  immediate  charge  of  the  institution.  Of 
those  officers  the  Medical  Superintendent  is  the  repre- 
sentative and  chief.  He  is  the  direct  executive  offi- 
cer and  the  responsible  head  of  the  asylum.  Its 
spirit  and  its  tone  are  embodied  and  incarnated  in 
him.  He  should  have  the  right  to  nominate  all  sub- 
ordinate officers,  and  to  appoint  and  dismiss  all 
attendants  and  other  employees.  He  should  be 
clothed  with  ample  authority,  should  be  allowed 
abundant  room  for  the  exercise  of  his  individual 
judgment  and  discretion,  and  should  be  held  to  a 
corresponding  accountability.  He  should  be  re- 
stricted in  his  methods  of  administration  bv  no  rules, 

tf 

except  such  as  are  clearly  necessary.  A  multitude 
of  petty  regulations  in  respect  to  the  details  of  inter- 
nal management,  enacted  by  legislators  or  govern- 
ing boards,  will  often  embarrass  and  hamper  a  con- 


62  TWENTY-FIVE   YEARS 

scientious,  good  man,  but  are  only  ropes  of  sand  in 
the  way  of  a  bad  one.  The  guaranty  of  right  conduct 
must  be  looked  for  in  the  man  himself,  and  not  in  the 
fetters  with  which  he  may  be  shackled. 

I  am  not  presumptuous  enough  to  attempt  a  fin- 
ished portrait  of  an  ideal  Asylum  Superintendent. 
It  is  mere  commonplace  to  say  that  he  should  possess 
ability,  integrity,  and  intelligence;  that  he  should 
have  a  thorough  knowledge  of  everything  which  con- 
cerns the  care  and  treatment  of  the  insane ;  and  that 
he  should  be  well  acquainted  with  all  forms  of  both 
healthy  and  morbid  mental  activity,  and  with  the 
relations  of  such  activity  to  bodily  conditions,  so  far 
as  these  have  been  discovered.  It  ought  to  be  safe 
to  assume  so  much  of  any  person  who  is  permitted  to 
be  a  candidate  for  the  Superintendency.  In  addition 
to  all  qualifications  of  this  nature,  he  should  be  a 
thoroughly  good  man,  in  the  best  and  highest  sense  of 
the  word  good — a  man  into  whose  hands  a  husband 
would  be  willing  to  place  the  health,  life,  and  honor 
of  a  helpless  and  defenseless  wife  or  daughter.  He 
should  be  the  embodiment  of  kindness  and  tender- 
ness, united  with  great  firmness  and  decision  of 
character.  His  sensibilities  should  be  keen  and 
quick,  while  he  needs  to  be  free  from  maudlin  senti- 
mentality. It  is  of  the  highest  importance,  also,  that 
he  have  power,  with  no  apparent  or  even  conscious 
effort,  to  impress  these  qualities  upon  his  associates 
and  employees.  His  purpose,  spirit,  tone,  and  temper 


WITH  THE   INSANE.  63 

should  pervade,  like  the  unseen  essence  of  peace, 
love,  and  mercy,  every  nook  and  corner  of  the  institu- 
tion. Out  of  him,  as  out  of  the  greater  Physician, 
should  go  virtue  to  heal,  calm,  and  restrain.  He 
should  possess  that  half -divine  something  which,  like 
a  hidden  magnet,  draws  out  into  spontaneous  activity 
the  very  best  of  everything  there  is  in  his  assistants 
and  subordinates.  He  thus  multiplies  himself  a 
hundred-fold,  and  is  constantly,  though  invisibly, 
present  everywhere  in  the  institution. 

In  such  men,  and  in  the  associates  and  helpers 
whom  they  naturally  gather  about  themselves,  are 
found  the  only  sufficient  guaranties  for  the  wise  and 
humane  treatment  of  the  inmates  of  an  asylum. 
Without  these,  all  other  provisions  will  have  little 
value ;  with  these,  the  danger  of  neglect  or  abuse  is 
reduced  to  the  lowest  possible  limit.  With  the  im- 
perfections of  human  nature,  it  can  never  be  wholly 
removed  from  public  institutions  or  from  private 
homes. 

A  lady  patient  of  most  excellent  spirit,  a  personal 
friend,  writes  as  follows: 

"  I  understand,  as  I  could  not  without  having  been  an  inmate 
of  such  an  institution,  how  entirely  a  patient  is  in  the  power  of 
doctors  and  attendants.  I  should  be  very  unwilling  to  trust 
myself  or  my  friends  to  an  institution,  without  knowing  the 

character  of  its  managers.     Dr.  is  one  of  the  kindest  of 

men.  As  one  of  the  ladies,  seven  years  a  patient,  expressed  it, 
'  He  is  a  father  to  us  all; '  and  it  was  a  general  feeling  among  the 
patients  that  he  was  their  friend  and  protector.  In  fact,  kindness 


64  TWENTY-FIVE   YEARS 

was  one  of  the  essential  things  in  treating  patients,  as  it  was  very 
difficult  to  do  anything  for  them  without  first  gaining  their  con- 
fidence." 

This  extract,  which  expresses  the  feelings  of  every 
intelligent  patient  with  whom  I  ever  conversed  in 
respect  to  the  relation  of  the  inmates  to  the  physi- 
cians and  employees,  suggests  a  few  words  touching 
the  position  and  duties  of  the  attendants  in  an  asy- 
lum. The  importance  of  their  character  and  duties 
to  the  immediate  comfort  and  well-being  of  patients 
can  not  be  rightly  estimated  by  any  one  unacquainted 
with  the  interior  organization  and  arrangements  of  an 
institution  for  the  insane.  They  stand  nearer  to 
the  patients,  in  many  respects,  than  the  physicians. 
It  is  in  their  power  to  make  life  to  the  inmates  not 
only  tolerable,  but  comparatively  happy.  It  is 
equally  within  their  power  to  render  life  anything 
but  tolerable  and  happy. 

A  Medical  Superintendent  says,  "Of  all  the  means 
used  in  the  institution  for  the  comfort  and  restoration 
of  the  inmates,  the  most  important,  perhaps,  is  per- 
sonal attendance.  It  alone  is  applicable  to  each 
individual  case,  and  is  available  by  night  as  well  as 
by  day.  Upon  its  character  and  efficiency,  and,  more 
than  all  else,  upon  its  spirit,  the  success  of  treatment 
in  many  cases  largely  depends.  With  the  most  com- 
plete architectural  arrangements,  unlimited  resources, 
and  skillful  medical  care,  discouraging  failure  may 
often  attend  when  remedial  effort  is  applied  through 


WITH  THE   INSANE.  65 

harsh,  ill-mannered,  and  ill-tempered  attendants.  The 
spirit  in  which  a  request  for  even  a  drink:  of  water  or 
the  adjustment  of  a  pillow  is  met,  may  give  to  a  fee- 
ble, depressed  patient  quiet,  health,  restoring  sleep,  or, 
on  the  other  hand,  a  night  of  restless  irritability." 

Another  says,  "  It  is  undeniable  that  the  efficiency 
and  usefulness  of  an  asylum  are  largely  promoted  by 
a  careful,  painstaking  corps  of  attendants.  From  the 
peculiar  nature  of  mental  disease,  it  is  inevitable 
that  patients  must  be,  to  a  great  extent,  dependent 
upon  their  attendants  for  companionship,  personal 
care,  and  direction  in  occupation  and  amusement. 
In  sickness  the  attendant  is  the  assiduous  nurse ;  in 
convalescence,  the  faithful  and  attached  friend ;  and 
at  all  times  the  intimate  companion  of  the  patient. 
It  is  consequently  extremely  important  that  faithful, 
efficient,  self-denying,  conscientious  attendants  be 
engaged.  In  selecting  them  the  effort  is  constantly 
made  to  secure  the  services  of  persons  of  unexcep- 
tionable habits,  and  with  fitness  for  the  special  work. 
The  attendant  lives  with  his  patients,  eats  at  the 
same  table  from  the  same  fare,  occupies  rooms  simi- 
larly furnished  and  arranged,  and  is  in  every  sense  of 
the  word  an  attendant. 

"The  effort  is  constantly  made  to  develop  the  fam- 
ily spirit,  as  it  may  be  termed.  Each  ward  is  under 
the  special  charge  of  a  person  of  experience,  who  for 
all  practical  purposes  is  like  the  head  of  a  family  in 
the  best  sense  of  the  word.  He  is  made  responsible 


66  TWENTY-FIVE   YEARS 

for  the  work  of  the  hall  and  for  the  comfort  and 
welfare  of  the  patients  committed  to  his  care,  and  is 
furnished  with  as  much  assistance  as  the  work 
requires." 

In  the  character,  habits,  and  training  of  these 
attendants  is  found  a  guaranty  for  the  comfort  and 
humane  treatment  of  the  insane,  scarcely  less  valu- 
able than  that  found  in  the  character  of  the  Superin- 
tendent and  his  immediate  associates.  The  lady  from 
whose  communication  I  have  already  quoted  says, — 

"In  the  fall  of  1873,  finding  I  was  losing  control  of  my  mind, 
and  fearing  to  lose  it  wholly,  I  went  to  the  asylum  voluntarily. 
I  had  all  confidence  in  the  institution,  from  long  acquaintance 
with  some  of  the  attendants  who  had  been  there  for  years.  I 
was  placed  in  the  convalescent  hall,  and  can  speak  confidently 
of  that.  I  received  the  most  careful  attention  and  kindest  possi- 
ble treatment  from  doctors  and  attendants;  and  my  case  was  not 
exceptional.  In  this  hall  were  gathered  ladies  from  all  the  other 
wards,  who  had  been  removed  there  from  time  to  time,  as  their 
condition  warranted.  As  there  was  no  restriction  placed  upon 
our  social  intercourse,  I  gathered  from  the  general  tone  of  remark 
by  patients  and  attendants  from  different  halls,  that  harsh  treat- 
ment was  censured,  and  that  any  attendant  who  was  not  uni- 
formly kind  to  the  patients  was  certain  of  dismissal,  if  the  facts 
were  known  at  bead-quarters." 

There  is  a  most  unfortunate  inclination  in  the  com- 
munity generally  to  criticise  and  censure  the  attend- 
ants employed  in  an  asylum.  They  are,  in  some 
quarters,  still  spoken  of  as  "keepers,"  and  are  pic- 
tured as  hardened,  unfeeling  wretches.  Nothing 
could  be  more  unjust  than  such  imputations  upon 


WITH  THE   INSANE.  67 

those  with  whom  I  have  been  acquainted.  With 
only  very  rare  exceptions,  they  have  been  young 
men  and  women  of  unusual  excellency  of  character, 
of  refined  manners,  and  of  good  taste.  They  will 
rank  in  culture  and  intelligence,  not  with  the  ordi- 
nary domestics  of  the  family,  but  with  the  average 
pupils  of  our  grammar  and  high  schools.  Many  of 
them  have  been  teachers,  and  have  exchanged  the 
uncertain  position  of  the  school  for  a  more  perma- 
nent one  in  the  asylum.  To  secure  and  retain  such 
attendants,  a  rate  of  wages  must  be  paid  fully  equal 
to  that  received  by  teachers  in  the  common  schools. 
To  say  nothing  of  justice  to  the  employees,  true 
economy  and  the  highest  interests  of  the  institution 
unite  in  demanding  such  compensation,  since  good 
attendants  can  be  secured  and  retained  in  no  other 
way. 

Many  of  the  duties  necessarily  required  of  the 
employees  upon  some  of  the  wards  of  an  asylum  are 
of  the  most 'taxing  and  trying  nature.  The  sick  are 
to  be  cared  for  night  and  day.  Patients  of  degrad- 
ing and  uncleanly  habits  are  to  be  kept  in  a  whole- 
some condition  of  body  and  clothing.  Excited  and 
•  disturbed  patients  are  to  be  quieted  and  prevented 
from  doing  injury  to  themselves  or  to  others,  and  all 
parts  of  the  hall  are  to  be  kept  in  good  order  and  free 
from  dirt.  Some  of  these  duties  are  so  distasteful, 
not  to  say  repulsive,  to  the  finer  feelings  and  delicate 
sensibilities  of  our  nature,  that  even  near  relatives 


68  TWENTY-FIVE   YEARS 

and  personal  friends  find  it  not  easy  to  continue  to 
perform  them  for  any  protracted  period.  There  is 
need  of  a  character  permeated  through  and  through 
with  the  noblest  of  principles,  and  reinforced  by  all 
available  motives,  if  such  work  is  to  be  done  thor- 
oughly and  conscientiously,  day  by  day  and  night  by 
night,  when  there  is  no  rational  human  eye  to  see, 
nor  ear  to  hear,  nor  tongue  to  report  That  divine 
love  which  "  suffereth  long  and  is  kind,  which  bear- 
eth  all  things,  endureth  all  things,  and  is  not  easily 
provoked,"  will  here  find  excellent  opportunity  for 
exercise.  I  am  glad  to  bear  witness  to  the  self-re- 
straint, zeal,  fidelity,  patience,  and  tenderness  of  many 
attendants  whom  I  have  known.  The  outside  world 
and  the  casual  visitor  can  never  properly  estimate 
this  service. 

The  securities  afforded  by  the  guaranties  here 
described  will  be  greatly  increased  by  the  force  of  an 
enlightened  and  just  public  sentiment  in  the  commu- 
nity at  large.  Under  the  influence  of  such  a  senti- 
ment, there  will  be  a  disposition  to  provide  all 
necessary  means  for  the  protection  and  care  of  the 
insane,  a  correct  estimate  of  the  value  of  proper 
and  timely  treatment  of  those  attacked  with  mental 
disease,  and  a  more  generous  appreciation  of  the  ser- 
vices of  physicians  and  others  employed  in  asylums. 
Civilized  men  are  not,  unless  overcome  by  passion  of 
some  sort,  deliberately  and  needlessly  cruel  to  their 
fellows.  Misfortune  and  suffering  touch  their  pity 


WITH   THE   INSANE.  69 

and  sympathy,  and  helplessness  does  not  -usually 
appeal  in  vain  for  succor  and  protection.  But  intel- 
ligence is  needed,  that  pity,  sympathy,  and  compas- 
sion may  be  wisely  directed. 

Public  sentiment  has  undoubtedly  improved  within 
the  last  few  years.  More  correct  notions  are  enter- 
tained of  the  nature  of  insanity,  of  its  causes,  and  of 
the  means  by  which  it  may  be  relieved  or  cured. 
Facts,  however,  compel  the  humiliating  confession 
that  much  of  ignorance  and  of  old  prejudice  still  sur- 
vives, and  is  sometimes  found  in  quarters  where  we 
would  not  expect  to  meet  it.  Physicians  and  clergy- 
men, on  account  of  the  peculiar  and  intimate  rela- 
tions which  they  sustain  to  the  sick  and  their  families 
and  friends,  can  do  more  than  persons  in  other  pro- 
fessions and  employments  to  enlighten  the  people. 
Next  to  these,  teachers,  especially  in  the  higher  insti- 
tutions of  learning,  have  the  largest  opportunities  to 
do  valuable  service  in  this  direction.  In  schools 
where  mental  science  is  taught,  attention  should  be 
directed  to  the  most  obvious  causes  and  peculiarities 
of  morbid  mental  action,  and  to  the  influence  of  harm- 
ful habits,  both  of  mind  and  body. 


70  TWENTY-FIVE   YEARS 


CHAPTER  IX. 

TREATMENT    OF    THE    INSANE    OUTSIDE    OF   ASYLUMS. 

As  already  remarked,  the  disposition  to  criticise  the 
interior  management  of  asylums  is  very  general. 
There  is  a  singular  readiness  to  accept,  "without  ques- 
tioning, all  tales  of  abuse  and  neglect,  however  im- 
probable they  may  appear.  Less  eagerness  is  mani- 
fested to  learn  facts  concerning  the  condition  and 
treatment  of  the  insane  in  and  about  our  own  homes, 
in  the  immediate  communities  and  neighborhoods 
where  misfortune  has  overtaken  them.  The  character 
of  private  places  of  confinement  and  of  public  recep- 
tacles is  not  often  a  subject  of  examination  or  com- 
plaint. Much  unnecessary  suffering  could  easily  be 
prevented,  if  attention  should  turn  itself,  with  wise 
discrimination,  to  local  occurrences  and  circumstances, 
and  should  insist  upon  the  removal  or  cure  of  evils 
within  sight  and  hearing  of  one's  own  doors,  with  the 
same  zeal  and  earnestness  which  it  manifests  for  the 
correction  of  those  at  a  greater  distance.  A  few  cases 
which  have  come  to  my  personal  knowledge  may  be 
safely  taken  as  types  of  a  multitude  of  others  which 
have  found  no  record.  These  indicate  the  existence 
of  a  wide  field  open  for  cultivation  in  the  interests  of 
humanity  and  charity,  and  so  near  at  hand  as  to  be 
accessible  to  all. 


WITH  THE   INSANE.  71 

A  soldier  from  one  of  the  rich  counties  of  my 
adopted  State  died  of  starvation  and  disease  in  a 
prison-pen  during  the  civil  war.  He  left  a  young 
widow  with  two  little  children  in  destitute  circum- 
stances, in  the  midst  of  a  well-to-do  community. 
Within  a  short  time  the  little  ones  sickened  and  died, 
and  the  widow  was  alone  and  childless.  She  was  of 
unblemished  life  and  reputation,  and  not  altogether 
uncultivated  in  mind  and  tastes.  The  shock  of  these 
repeated  sorrows  was  too  much  for  her  weakened 
body  and  unstrung  nerves.  Her  mind  gave  way,  and 
a  mild  and  inoffensive  form  of  insanity  came  upon 
her.  She  heard  voices  calling  her  —  the  voices  of  her 
martyred  husband  and  her  lost  children.  She  wan- 
dered about  the  neighborhood,  and  at  night  went  into 
the  grave-yard  near  by  and  slept,  if  sleep  came  to  her 
relief  in  her  sadness,  with  her  head  pillowed  upon  the 
new-made  graves  of  her  children.  The  neighbors 
pitied  and  sympathized,  and  did  what  uninstructed 
kindness  could  do.  The  chill  evenings  and  biting 
frosts  of  autumn  and  early  winter  came;  and  one 
morning  she  was  found  helpless  and  half-dead  from 
exposure  to  the  cold  night  air.  Restored  a  little,  she 
was  sent,  in  a  farmer's  wagon,  to  the  county  officer 
whose  duties  included  the  care  of  the  poor  and  unfor- 
tunate. When  she  was  brought,  he  happened  to  be 
sitting  in  a  public  place  with  some  boon  companions. 
In  the  most  unfeeling  manner,  he  jested  on  her  visits 
to  the  "bone-yard,"  as,  in  his  refined  vernacular,  he 


72  TWENTY-FIVE   YEARS 

named  the  resting-place  of  her  lost  little  children. 
"Voices  call  me,"  she  said  in  weak  and  piteous  tones. 
"Whose  voices?  what  voices?  where  do  they  come 
from?"  said  the  humane  conservator  of  the  public 
interests.  "I  can  not  tell  whence  they  come,"  she 
replied  in  the  same  sad  tones.  "Perhaps,"  said  the 
officer,  ''they  come  from  Chicago;  may  be  your  hus- 
band calls  you  there.  Would  you  like  to  go  and 
see?"  "0,  anywhere  to  find  my  husband,"  said  she; 
"O,  send  me  to  him."  The  price  of  a  railroad  ticket 
to  Chicago  was  paid ;  the  impoverished  county  was 
freed  from  the  charge  of  an  insane  pauper;  the  faith- 
ful public  officer  chuckled  at  his  economical  shrewd- 
ness, and  the  soldier's  widow  and  bereaved  mother 
went  alone,  friendless  and  penniless,  bereft  of  hope 
and  reason,  to  plunge  into  the  seething  vortex  of  a 
great  and  wicked  city.  Language  is  utterly  inade- 
quate to  make  fitting  comment  on  a  case  like  this. 

Another  example,  less  piteous  in  its  termination, 
illustrates  the  same  tendency  to  allow  considerations 
of  so-called  economy  to  outweigh  all  regard  for 
humanity.  The  home  of  a  wife  and  mother  had 
been  wrecked  and  ruined  by  a  drunken  husband. 
The  widow  depended  upon  the  labor  of  her  children 
and  her  own  efforts  for  her  support.  Two  stalwart 
sons  enlisted  in  the  ranks  of  the  army  which  saved  a 
nation's  life.  They  died  victims  of  lingering  disease 
and  starvation,  in  the  delirium  which  hunger  often 
produces.  A  surviving  comrade  told  the  harrowing 


WITH  THE   INSANE.  73 

tale  to  the  mother.  Its  horrors  were  too  much  for 
powers  weakened  by  anxiety  and  suffering.  She 
became  insane.  Her  disease  was  not  violent  in  form, 
but  unfitted  her  to  care  for  herself,  and  the  remain- 
ing members  of  the  family  were  unable  to  provide 
suitably  for  her  support  and  protection.  Her  resi- 
dence happened  to  be  on  the  borders  of  the  Common- 
wealth. She  was  consequently  tossed  across  State 
lines  and  then  over  county  lines,  finding  no  rest  and  lit- 
tle pity.  At  last  she  was  fortunate  enough  to  fall 
among  public  officers  who  did  not  forget  that  they  were 
men  and  were  born  of  mothers,  and  who  did  not  lay 
aside  humanity  when  they  assumed  a  little  brief  official 
responsibility.  Through  their  efforts  she  found  in  an 
asylum  a  home,  more  than  earned  by  the  sacrifice  of 
her  sons,  where  proper  care  will  smooth  the  path 
down  which  tottering  age  goes  to  its  quiet  resting- 
place. 

As  I  am  writing,  my  eye  rests  upon  the  following 
item  in  a  daily  paper  published  in  the  present  year  of 
grace.  The  circumstances  are  not  within  my  per- 
sonal knowledge,  but  they  seem  well  authenticated. 

"There  has  been  found  in ,  confined  in  a  filthy  pen,  in 

a  nude  condition,  a  woman  sixty  years  of  age  and  a  lunatic. 
She  owns  considerable  property.  She  has  been  kept  in  her 
present  condition  from  the  economy  of  relatives.' 

It  would  be  easy  to  multiply  instances  of  a  simi- 
lar and  of  a  more  shocking  nature.  These  are  suffi- 
cient to  indicate  the  need  of  circumspection  which 


74  TWENTY-FIVE  YEARS 

can  see  things  near  at  hand.  A  superintendent  of 
the  Kalamazoo  Asylum,  in  speaking  of  some  persons 
received  into  the  institution,  says: 

"  They  have  sometimes  come  to  us  in  a  condition 
not  pleasant  even  to  describe  —  often  with  but  few 
traces  of  humanity  left.  To  bring  these  emaciated, 
broken-down  individuals  up  to  their  previous  stand- 
ard of  physical  health,  without  which  improvement 
is  impossible,  and  to  recall  habits  of  personal  cleanli- 
ness and  propriety,  is  generally  a  long  and  tedious 
process ;  yet  a  fair  proportion  of  them  have  left  the 
institution  so  much  improved  as  to  become  again 
pleasant  members  of  the  family  circle,  and  not  a  few 
were  subsequently  able  to  provide  for  themselves." 

Of  the  patients  received  during  the  first  years  after 
the  opening  of  the  asylum,  he  says,  "Of  the  adult 
females,  fully  ninety  per  cent  are  much  broken  in 
health  and  constitution.  Very  many  are  faithful, 
self-sacrificing  wives  and  mothers,  prostrated  by  toil 
and  anxiety,  and  maternity  met  under  peculiarly  try- 
ing circumstances,  where  the  only  nursing  received  is 
the  few  hours  snatched  by  kind  neighbors  from  their 
own  duties.  In  regarding  these  we  can  not  help  but 
feel  a  deeper  and  tenderer  sympathy  than  is  enlisted 
in  behalf  of  those  whose  sufferings  are  the  result  of 
their  own  imprudence." 

Sometimes,  without  doubt,  such  lack  of  proper 
care  for  the  wife  and  mother  has  been  through  no 
fault  of  the  husband  and  father,  or  of  other  friends ; 


WITH  THE   INSANE.  75 

"but  in  too  many  cases  it  has  been  the  result  of 
thoughtlessness  or  of  criminal  neglect  on  the  part  of 
those  who  had  abundant  means  to  furnish  all  needed 
care,  and  who  may  justly  be  held  responsible  for  the 
suffering  which  their  neglect  has  caused. 

An  early  report  states  that,  referring  to  the  record 
of  applications  for  those  admitted,  it  is  shown  that 
two  had  been  confined  for  many  months  in  cages, 
one  of  them,  as  it  was  expressed,  having  become  like 
a  wild  animal.  In  nine  cases  homicide  had  been 
attempted,  though  successfully  in  but  one.  In 
reference  to  two,  it  was  stated  that  no  one  could  with 
safety  enter  the  place  in  which  they  were  confined ; 
in  case  of  twenty-one  of  the  small  number  admitted, 
confinement  in  a  jail  had  been  deemed  necessary. 
The  devices  of  restraint  and  punishment  of  many 
presented  for  admission  certainly  surpass  those 
depicted  by  sensational  writers.  Intentional  cru- 
elty is  not  charged  upon  those  who  have  had  the 
care  of  these  persons.  The  bruises,  excoriations,  and 
fractures  found  upon  their  bodies ;  the  fetters  crowd- 
ing into  the  flesh;  the  firmly  rusted  irons,  and  the 
ridges  left  by  the  policeman's  club,  give  evidence 
rather  of  thoughtless  ignorance,  or  of  that  strange 
fear  with  which  the  insane  are  sometimes  still 
regarded." 

These  things  did  not  occur  in  the  "  dark  ages  "  of 
the  far-off  past.  They  are  not  imaginary  fictions  con- 
jured up  "to  point  a  moral  or  adorn  a  tale."  They 


76  TWENTY-FIVE   YEARS 

are  simple  recitals  of  facts  existing  about  us  and 
among  us  in  the  last  half  of  the  nineteenth  Christian 
century,  in  the  very  bosom  of  a  so-called  Christian 
civilization,  only  a  stone's  throw  from  the  school- 
house  and  the  church. 

There  is  need  of  guarding,  with  jealous  care,  the 
security  and  welfare  of  the  inmates  of  asylums. 
This  is  freely  conceded.  But  there  is  equal,  if  not 
greater,  need  to  devise  safeguards  for  the  protection 
and  humane  treatment  of  the  insane  in  the  jails, 
receptacles,  strong-rooms,  cages,  and  other  places 
where  ignorance,  fear,  or  false  economy  has  confined 
them. 


CHAPTER  X. 
OPINIONS  AND   FEELINGS   OF   PATIENTS. 

All  intimate  relationships  involve  communications 
of  a  confidential  character.  No  honorable  man,  under 
any  ordinary  circumstances,  will  make  these  known 
even  to  personal  friends,  much  Jess  to  the  public. 
The  physician  owes  silence  to  his  patients;  the  clergy- 
man to  his  parishioners ;  more  than  these,  the  officer 
of  an  asylum  is  bound  to  seal  his  lips  and  his  pen  to 
anything  the  relation  of  which  might  bring  a  blush 
to  the  cheek  or  a  pain  to  the  heart.  The  interior  of 
many  a  home  is  thrown  open  to  the  superintendent 
and  to  others,  in  an  institution  whose  inmates  have 
been  forsaken  by  judgment  and  discretion.  Skeletons 


WITH  THE   INSANE.  77 

are  uncovered  whose  existence  few  even  suspect.  All 
such  revelations  are  buried  and,  as  far  as  may  be,  for- 
gotten. I  shall,  consequently,  speak  only  of  things 
which  belong  outside  the  veil  of  confidence,  but 
which  none  the  less  enable  one  to  understand  a  little 
of  the  experience  of  the  insane  themselves. 

My  observation  has  left  no  doubt  in  my  own  mind 
that  to  some  patients  the  asylum  is  a  place  of  intense 
mental  suffering.  To  them  it  is  a  "palace-prison"  of 
most  irksome  restraint  and  confinement.  They  al- 
most constantly  fret  and  chafe  against  necessary  rules 
and  regulations.  In  their  own  estimation  they  are 
not  mentally  diseased,  but  are  unjustly  and  wrongly 
deprived  of  liberty,  either  by  the  machinations  of 
enemies  or  by  the  treachery  of  relations  and  pretended 
friends. 

These  patients  have  usually  a  good  degree  of 
mental  activity,  often  speak  fluently  and  rationally, 
excepting  upon  some  particular  topic,  and  write  with 
much  vigor  and  sharpness.  The  casual  visitor  will 
look  upon  them  with  great  interest,  and  will  be 
likely,  if  he  does  not  tarry  too  long,  to  question  their 
insanity.  In  most  cases  they  seem  to  have  inherited 
a  defective  physical  organization  and  a  predisposition 
to  some  form  of  cerebral  disease.  Under  some  un- 
fortunate combination  of  circumstances  their  nervous 
systems  have  been  overtaxed.  They  have  lost  self- 
control,  and  have  fallen  under  the  power  of  some 
absorbing  delusion.  In  this  condition  they  become 


78  TWENTY-FIVE   YEA^S 

unsafe  members  of  society,  frequently  a  source  of 
danger  to  their  friends,  and  often  incapable  of  caring 
properly  for  self-protection.  If  educated  and  ambi- 
tious, it  is  not  unusual  for  them  to  imagine  that  some 
great  and  peculiar  mission  has  been  imposed  upon 
them,  to  the  accomplishment  of  which  life  should  be 
sacredly  devoted.  Of  this  class  more  females  than 
males  have  come  to  my  notice.  The  extracts  given 
below  from  letters  addressed  to  me  by  a  young  lady 
will  show  the  intensity  of  feeling  to  which  patients, 
suffering  under  this  form  of  mental  impairment,  are 
subject.  The  lady  was  a  graduate  of  a  literary  insti- 
tution of  high  rank,  and  possessed,  in  certain  direc- 
tions, ability  above  the  average  of  her  associates. 
My  acquaintance  with  her  began  before  her  admission 
to  the  asylum. 

SIR:  —  I  wish  I  might  stir  your  heart  and  the  hearts  of  your 
coadjutors  to  justice  and  humanity.  Not  to  weakly  give  my 
confidence  that  it  may  be  used  against  me  shall  I  write  as  I  do, 
hut  I  have  depended  on  you,  almost  in  a  frenzy  of  despair,  to 
liberate  me.  Can  you  fail  me?  I  can  not,  can  not  stay.  They 
have  hurt  me  so.  It  kills  me.  Only  superlatively  painful  ex- 
periences await  me  here,  and  to  succeed  in  their  schemes  for  me 
is  as  im/wssible  to  them  as  it  would  be  to  turn  the  planets  from 
their  courses.  You  can  arrange  for  my  friends  to  come  for  me 
and  take  me  to  their  owa  tender  care,  or  rather  to  liberty  and 
long  rest  from  disturbing  causes,  that  systematic  labor  may  once 
more  be  possible  to  me,  and  the  right  be  mine  to  live  according 
to  the  dictates  of  reason  and  conscience,  and  sway  the,  influence 
a  responsible  being  should,  untrammeled  by  authority  and  bru- 
tality. I  believe  in  myself,  and  will  not  yield  to  the  conspiracy 
against  me,  though  all  the  world  were  in  the  league. 


WITH  THE   INSANE.  79 

I  can  not  be  ruined  so.  I  must  go.  Keep  me,  if  you  dare. 
They  need  not  fear  what  I  will  say.  They  can  say  I  was  insane. 
But  all  the  imputations  of  insanity  placed  on  me  are  false,  and 
with  eyes  intelligently  open  I  have  tried  to  save  my  brain. 
Talent  and  character  were  to  make  my  way,  and  they  have  tried 
to  rob  me  of  both.  .  .  .  Can  you  imagine  anything 
worse  than  a  heart  and  brain  crushed  by  all  the  hellish  devices 
the  arch-fiend  could  prompt,  under  the  regime  of  a  beastly  dragon 
of  a  woman?  In  the  effort  to  make  me  of  like  passions  with 
themselves  they  have  spared  no  pains  to  tear  me  from  my  moor- 
ings of  religion  and  eradicate  all  I  hold  dear. 
Could  you  know  all  of  thought,  emotion,  and  purpose  that  have 
been  born  and  died  within  me  the  past  year,  you  would  surely 
say,  this  brain-wear  were  better  devoted  to  practical  purposes. 
It  never  can  be  here.  Shall  any  tell  of  good  deeds  wrought  here 
by  me?  No!  They  thwarted  it  by  their  fiendish  malignity  and 
brutality.  I  long  for  release  to  care  for  myself,  and  do  my  duty 
t>y  those  who  have  done  so  much  for  me.  Those  who  have  done 
all  they  could  to  ruin,  need  pretend  no  solicitude  for  my  future. 
I  have  none.  But  I  am  not  the  woman  to  be  so  trifled  with,  and 
will  not  endure  it  longer.  It  is  fearful  to  have  them  prevent  my 
honest  industry,  and  ruin  one  of  the  best  brains  God  ever  gave  a 
woman.  I  must  not  plead  in  vain  any  longer. 

Yours,  etc., 


»'i  Mingled  with  the  entreaties,  which  came  from 
her  very  so  ill,  were  passages  indicating  the  fearful 
hold  which  the  fatal  delusion  had  upon  her  mind. 
Later,  after  it  was  evident  to  her  that  hope  of  libera- 
tion through  me  had  failed,  she  wrote  as  follows : 

SIR:  — Because  you  mocked  my  last  hope  that  you  would  do 
what  you  could  in  remedying  the  wrong  you  did  in  sending  me 
here,  by  informing  my  friends  of  my  desire  to  be  with  them,  my 
faith  in  your  character  is  completely  shivered.  Two  months 
and  a  half  since,  that  letter  implored  your  aid,  and  now  I  am 


80  TWENTY-FIVE    YEARS 

going  to  write  a  letter  for  you  to  keep  and  read  to  revive  your 
drooping  energies  and  spur  your  zeal  for  humanity.  .  .  *  . 
If  you  can  demonstrate  that  it  is  wise  to  come  in  contact  with 
vice,  except  to  rebuke  it;  or  sickness,  except  to  relieve  it;  or  to  live 
degraclingly  when  one  might  live  nobly,  then  could  you  be  guilt- 
less in  allowing  me  to  remain*  But  because  you  have  suffered 
me  to  languish  here,  I  want  you  to  think  of  me  when  you  gather 
around  your  well-spread  table  in  the  society  of  cultured  friends. 
I  want  you  to  see  pictures  of  mad-house  revels  in  the  fire-light. 
I  hope  the  wild  winds  of  winter  will  shriek  in  your  ears  of  my 
misery.  When  you  retire  to  rest  think  of  maniac  shrieks, 
moans,  and  coughs  I  sometimes  hear.  In  your  honored  position 
of  usefulness,  think  how  I  am  wasting  my  time  and  talents. 
The  suttee  is  abolished;  the  horrors  of  the 
Inquisition  have  ceased ;  American  slavery  is  dead.  Russia  owns 
no  serfs;  but  Michigan  has  an  institution  where  sane,  innocent 
women  may  be  thrown  into  a  smelting  furnace  among  seething 

specimens  of  humanity,  to  be  molded  into  such  shape  as  

thinks  proper.  Every  softened  lineament  may  be  stricken  from 
the  features;  nearly  every  noble  emotion  from  the  soul.  Remem- 
ber all  this  when  thankful  men  and  women  come  to  you  and 
say,  "You  have  saved  me,  under  God."  Remember  that  man 
may  praise  and  admire  you,  but  God  looks  on  the  heart.  To 
him  you  must  answer  for  this  wrong;  with  him  I  leave  you;  as 
for  me  I  have  learned  that  it  is  better  to  trust  him  ' '  than  to  put 
confidence  in  princes." 

Yours,  with  all  due  respect, 

P.  8.  The  subject  is  inexhaustible.  Go  your  way!  Wrap 
the  filthy  rags  of  your  righteousness  closely  about  you,  and  be 
careful  about  sending  another  sane,  virtuous  woman  to  be 
placed  in  the  hands  of  those  who  were  more  respectably  occu- 
pied in  cock-fighting  and  bull-baiting  than  in  doing  violence  to 
all  the  holiest,  best  feelings  of  a  woman's  nature. 

This  letter  also  contained,  in  the  suppressed  pas- 
sages, striking  illustration  of  the  strength  of  her 


WITH    THE    INSANE.  81 

delusion.  It  is  a  well-recognized  fact  that  insanity  of 
certain  types  manifests  itself  much  more  fully  and 
clearly  in  the  writing  than  in  the  conversation  of  the 
patient.  I  can  hardly  imagine  a  situation  more  tor- 
turing to  the  soul  than  that  of  a  person  afflicted  with 
this  form  of  mental  disorder.  Trust  in  humanity  and 
trust  in  God  usually  die.  Hope  gradually  fades 
away,  and  relief  comes,  in  a  majority  of  cases,  only 
through  the  decay  of  mental  power  which  confine- 
ment probably  hastens.  Heart-rending  tales  like 
that  of  the  "  Palace-prison  "  have  their  origin  in  cases 
of  this  kind. 

The  extracts  next  following  indicate  a  type  of 
mental  aberration  which  not  only  does  not  give  pain 
mentally  to  the  patient,  but  on  the  contrary  seems  to 
afford  an  almost  unlimited  source  of  enjoyment.  The 
imaginary  possession  of  divine  power  is  a  delusion 
not  uncommon,  particularly  among  males. 

To  THE  MEDICAL  FRATERNITY  THROUGHOUT  THE  EARTH: 

Glory  to  God  in  the  Highest ! ! !  Peace,  good  will  unto  all  men 
that  shall  obey  my  royal  will  and  pleasure,  from  this  time  hence- 
forth and  forever.  Amen!  Amen!!  Amen!!!  I  am  the  Alpha 
and  the  Omega,  the  beginning  and  the  end,  the  first  and  the  last. 
"I  am  the  vine."  I  am  the  fulfillment  of  God's  promise  to 
David,  1st  Book  of  Chronicles,  17  chapter,  llth  to  and  including 
the  15th  verse;  Psalms  the  2d,  7th  verse  to  the  end;  Revelation, 
19th  chapter,  16th  verse.  I  am  the  Lord  thy  God,  and  thou  shalt 
have  none  other  God  beside  me.  My  yoke  is  easy  and  my  burden 
is  light.  Love  one  another. 

(Signed) , 

King  of  Kings  and  Lord  of  Lords. 


82  TWENTY-FIVE   YEARS 

ORDER  No.  2. 

To  E.  H.  Van  Deusen,  M.  D.,  Principal;  George  C.  Palmer,  M.  D., 
1st  Assistant;  E.  O.  Marshall,  M.  D.,  2d  Assistant. 

KALAMAZOO,  MICHIGAN,  INSANE  ASYLUM. 
MY  DEAR  SIRS,  BROS.,  COMPS.,  AND  SIR  KNIGHTS:— You  will 
instruct  all  in  authority  under  you,  from  this  time,  henceforth 
and  forever,  to  obey  my  royal  will  and  pleasure  in  all  things  that 
I  may  desire  or  ask  for;  to  open  all  Doors  at  my  command,  fur- 
nish all  necessary  information,  and  attend  in  every  respect  to  my 
royal  will  and  pleasure.  For  my  yoke  is  easy  and  my  burden  is 
light.  Amen!  Amen!!  Amen!!! 

Royal  Palace  of  the  King  of  Kings  and  Lord  of  Lords,  Kala- 
mazoo,  Mich. 

(Signed) , 

King  of  Kings  and  Lord  of  Lords. 

KALAMAZOO  INSANE  ASYLUM, 

FEB.  28,  1874. 

Shortly  after  I  was  thirty-five,  I  took  up  the  Lord's  Power,  or 
the  Power  which  the  Lord  Jesus  laid  down;  which  gave  me  full 
Power,  which  is  the  Power  of  the  Lord.  And  at  that  time,  the 
10th  of  April,  1866,  I  received  a  mark  on  my  left  side  like  unto  a 
wound,  which  was  healed,  which  indicated  and  signified  that  the 
head  which  was  wounded  unto  death  was  healed  and  restored  to 
power.  .  .  .  . 

SEPT.  17,  1875. 

To  DR. : — I  have  transmitted  evidence  to  you  that  a 

general  doom  is  settling  on  the  human  race,  unless  certain  con- 
ditions are  complied  with;  if  those  conditions  are  not  complied 
with,  the  doom  of  the  human  race  will  be  sealed  the  last  day  of 
next  February. 

Now,  the  way  to  prevent  the  doom  of  the  human  race  from 
settling  down  is  to  comply  with  what  is  demanded  and  required. 
Submit  to  the  burdens  which  the  Lord  imposes. 

I  demand  and  require  of  you  to  force  the  battle  and  doom  on 
to  the  President  and  Vice-President  with  sword  and  saber,  and 


WITH    THE    INSANE.  83 

•with  shot  and  shell,  and  horse  and  rider,  and  to  strike  for  life. 
Authority  is  found  in  being  the  Lord. 
Written  by  the  Creator  of  all  things. 

Truly, . 

The  feelings  of  many  restored  patients,  toward  the 
asylum  and  its  officers,  may  be  gathered  from  the 
tone  of  the  letters  which  follow.  These  are  samples 
of  letters  frequently  received  by  the  Superintendent 
and  others  connected  with  the  institution.  They 
were  addressed  to  me  with  no  expectation  of  their 
publication. 

DEAR  SIR: —  In  the  hope  of  seeing  and  conversing  with  you 
again  before  departing  from  the  asylum,  I  bade  you  adieu 
without  expressing  the  great  obligations  I  am  constrained  to  feel 
myself  under  to  you,  in  common  with  my  other  kind  friends, 
•whose  instruction  and  influence  contributed  so  much  to  my 
restoration  to  health  and,  what  is  of  almost  infinitely  greater 
value,  to  reason.  You  may  be  surprised  when  I  tell  you  that  of 
all  the  influences  brought  to  bear  upon  my  wandering  mind  and 
despairing  heart,  none  were  more  effective  in  restoring  that 
mind  to  a  healthy  tone,  and  illumining  that  heart  with  the  light 
of  hope,  than  the  simple  religious  exercises  conducted  by  your- 
self. It  had  been  many  months  since  I  had  listened  to  any  relig- 
ious exercises,  and  the  very  name  of  Jesus  was  like  a  sweet  but 
long-forgotten  strain  of  music  to  my  ear.  I  always  feel  that  I 
should  like  of  all  things  to  converse  with  you  upon  the  themes  so 
dear  to  every  soul  that  has  once  realized  its  own  siufulness,  or 
sought  and  hoped  for  mercy  at  the  feet  of  a  loving  Saviour.  But 
whenever  you  came  there  seemed  to  be  so  many  who  were  really 
greater  sufferers  than  myself,  to  claim  your  sympathy  and  atten- 
tion, that  I  was  fain  to  deny  myself  the  pleasure  of  seeking 
words  of  instruction  and  encouragement  for  myself  during  your 
-very  welcome  visits.  Having  lost  this  very  desirable  opportunity, 
I  will  endeavor  to  make  amends  to  myself  by  talking  with  you  a 


84  TWENTY- FIVE   YEARS 

little  bit  on  paper,  with  your  consent,  upon  subjects  of  vital 
importance  to  me,  as  they  involve  my  spiritual  well-being.  I 
said  to  you  that  I  hoped  that  I  was  a  Christian,  and  I  do  trust  I 
am  not  presumptuous  in  thus  hoping,  still  less  in  trying  to  regulate 
my  life  by  the  law  of  Christ,  seeking  to  bring  every  thought  into 
captivity  to  his  will.  But  when  I  look  back  upon  my  past  life, 
when  I  for  a  moment  turn  my  eye  upon  my  own  heart,  I  become 
doubtful,  and  that  heart  fails  me  for  fear.  My  Christian  expe- 
rience (if  I  have  had  any  genuine  religious  exercises)  has  been  of 
a  somewhat  extraordinary  character,  in  which  mere  feeling  had, 
I  fear,  too  great  a  share.  You  may,  however,  be  better  able  to 
judge  of  this  when  you  know  something  of  my  education  and 
training.  [Here  is  given  a  frank  recital  of  personal  history  and 
experience,  deeply  interesting  and  touching  in  its  character,  but 
intended,  as  indeed  the  whole  letter  was,  only  for  the  eye  of  a 
sympathizing  friend.] 

Excuse  my  prolix  epistle,  and  be  so  kind  as  to  answer. 
Ever  your  grateful  friend, 

MY  DEAR  FRIEND  AND  BROTHER: — My  only  apology  for  this 
intrusion  is  that  I  know  it  will  rejoice  your  heart  to  hear  from 
me  that  my  reason  is  perfectly  restored,  and  my  physical  health 
is  much  improved,  my  confidence  in  the  blessed  God  more  firmly 
established  than  ever,  and  the  precious  promises  of  the  dear 
Savior  a  more  perfect  rest  to  my  soul.  I  also  thought  it  would 
encourage  your  heart  and  strengthen  your  efforts  in  your  labors 
of  love  with  those  poor  afflicted  ones,  with  whom  I  was  so  long 
associated,  to  know  that  your  self-denial  has  not  been  in  vain. 
Your  weekly  visits,  prayers,  and  exhortations  were  so  refreshing 
to  me,  and  seemed  to  be  the  blessed  means  of  re-awakening  that 
light,  love,  joy,  and  peace  which  I  had  before  enjoyed,  and  which 
I  still  retain.  Last  Sabbath  I  received  the  Holy  Sacrament  of  the 
Lord's  Supper,  for  the  first  time  in  two  years.  You  may  be  sure 
it  was  to  me  not  only  a  solemn,  but  also  a  most  delightful  season. 
The  elders  received  me  at  the  sacred  altar  with  tears  of  sympathy 


WITH   THE    INSANE.  85 

and  holy  joy.     Bless  the  Lord,  O  my  soul,  and  forget  not  all  his 
benefits. 

Though  I  have  severe  trials  that  often  blind  my  eyes  with  tears, 
they  are,  thanks  to  our  heavenly  Father,  all  outward,  and  only 
serve  to  increase  and  confirm  the  imperishable  treasure  within. 
"In  the  world  ye  shall  have  tribulation,"  is  a  part  of  the  promise, 
"  but  in  me  ye  shall  have  peace."  Dear  brother,  my  heart  is  full, 
and  I  would  say  much  more,  but  fear  I  am  already  trespassing. 
I  would  be  affectionately  remembered  to  Mrs.  Putnam.  I  always 
think  of  the  pleasant  visits  at  your  house  with  grateful  pleasure. 

Yours, . 


CHAPTER  XI. 

SCHOOLS  AND   INSANITY. 

In  this  and  some  following  chapters  I  wish,  if  pos- 
sible, to  direct  attention  to  a  few  topics  of  practical 
importance.  It  is  not  anticipated  that  any  new 
truths  will  be  presented,  but  only  that  some  familiar 
ones  may  be  looked  at  from  a  different  direction. 

The  schools  have  been  accused  of  many  and  grave 
faults.  Like  scape-goats,  they  have  been  loaded 
down  with  a  huge  burden  of  "transgressions  and 
sins."  It  has  not,  however,  been  charged  that  they 
are  directly  responsible  for  any  considerable  amount 
of  mental  disease.  It  would  be  rank  treason  for  a 
teacher  to  whisper  that  such  a  charge  could  have  the 
shadow  of  foundation.  But  a  practiced  observer 
will,  in  many  cases,  discover  the  real,  original  cause 
of  insanity  far  back  of  the  assigned  one,  in  some 


86  TWENTY-FIVE   YEARS 

native  tendency  of  mind,  fed  and  fostered  by  unwis- 
dom of  parents  and  teachers.  Considerable  numbers 
of  both  students  and  teachers  are  found  in  the  asy- 
lums. It  would  not  be  strange  that  I  should  have 
had  a  special  interest  in  studying  such  cases.  I  have 
no  hesitation  in  affirming  that  the  arrangements  and 
methods  of  work  in  the  schools  are  pretty  directly 
responsible,  in  a  majority  of  instances,  for  the  insan- 
ity of  the  teachers  whose  cases  have  fallen  under  my 
own  observation.  Other  causes,  without  doubt,  have 
conspired  with  these,  but  to  those  the  sad  result  has 
been  mainly  due.  To  put  the  matter  in  the  briefest 
possible  form,  in  many  schools  the  organization  and 
administration  are  such  that  some  of  the  teachers, 
usually  ladies,  are  subjected  to  overwork  and  over- 
anxiety.  Unreasonable  demands  are  made  upon  both 
the  physical  and  mental  powers.  As  a  consequence, 
the  vital  energies  are  prematurely  exhausted ;  the 
nervous  system  is  broken  down ;  the  power  of  self- 
control  is  weakened  ;  depression  of  spirits  follows, 
and  finally  melancholia,  or  some  other  species  of 
mental  disease,  supervenes.  Recovery,  in  these 
cases,  is  doubtful.  The  best  that  can  ordinarily  be 
hoped  for  is  partial  restoration,  and  a  few  subsequent 
years  of  painful  and  enforced  inactivity  and  depend- 
ence. It  would  be  easy  to  recall  and  describe  spe- 
cific examples  by  way  of  illustration,  but  the  sanctity 
of  official  obligations  and  other  obvious  reasons  for- 
bid this. 


WITH    THE    INSANE.  87 

Many  female  teachers  are  required  to  control  and 
instruct  too  many  pupils,  to  teach  too  many  subjects, 
to  do  too  much  work  outside  the  school-room  in  pre- 
paring matter  for  lessons,  in  looking  over  and 
marking  "examination  papers,"  in  filling  up  blank 
reports,  and  in  other  kindred  labor.  They  are  com- 
pelled, by  methods  of  examining,  grading,  and  pro- 
moting pupils,  to  undergo  too  much,  too  frequent,  and 
too  long-continued  anxiety,  and  they  are,  in  not  a 
few  cases,  left  with  too  little  freedom  for  the  exercise 
of  individuality.  The  responsibility  for  these  evils 
rests  partly  upon  teachers  themselves,  more  upon 
principals  and  superintendents,  and  largely  upon 
school-boards  and  the  general  public. 

Little  interest  has  been  manifested  in  this  feature 
of  the  school  question.  It  has  received  no  discussion 
in  reports,  periodicals,  or  newspapers.  It  has  seemed, 
therefore,  the  more  needful  to  give  utterance  to  a  few 
words  of  unvarnished  truth  in  this  connection. 
Teachers  have  claims  upon  justice  and  humanity,  in 
common  with  the  children  whom  they  help  to  fash- 
ion into  manhood  and  womanhood. 

The  effects  of  school  requirements  and  discipline 
upon  the  whole  nature,  physical,  mental,  and  moral, 
of  pupils  have  been  topics  of  frequent  and  free  dis- 
cussion. Viewed  from  a  teacher's  position,  these 
discussions  have  involved  much  of  truth,  and  not  a 
little  of  misapprehension ;  and  occasionally  they 
have  manifested  a  lamentable  ignorance  of  facts  and 


88  TWENTY-FIVE   YEARS 

principles.  Schools  and  teachers  and  educational 
methods  are  justly  chargeable  with  grave  faults,  but 
they  are  not  the  sources  of  all  the  ills  under  which 
society  suffers.  Some  things  they  do  which  ought 
not  to  be  done ;  they  leave  undone  more  which  they 
should  do. 

Education  of  the  right  sort,  the  harmonious  devel- 
opment and  training  of  the  whole  complex  being  of 
the  child,  should  conduce  to  mental  health  and  vigor, 
and  should  do  much  to  prevent  insanity.  Schools 
are  not  hospitals  or  asylums,  and  it  is  not  their  prov- 
ince to  reform  criminals,  to  cure  bodily  diseases,  or 
to  heal  mental  maladies.  But  it  is  a  part  of  their 
legitimate  business  to  prevent  all  these.  They  are 
very  near  the  fountain  out  of  which  character  and 
conduct  flow.  They  should  help  to  guard  this  from 
pollution.  The  stream  of  young  life  ought  not  to  be 
poisoned  at  its  source.  In  the  interests  of  mental 
health  a  few  things  may  be  demanded,  with  a  good 
deal  of  emphasis,  of  the  home  and  school,  of  parents 
and  teachers.  Some  of  these  are  so  obvious  that 
their  mention  may  excite  surprise. 

(1)  Children  should  be  taught,  beginning  in  the 
home,  obedience  and  respect  for  authority.  The 
general  interests  of  society  demand  this ;  but  it  is  not 
urged  here  for  that  reason.  A  child  who  frets  and 
fumes  at  every  command  which  crosses  his  inclina- 
tions, at  every  requirement  for  which  he  can  not 
comprehend  the  purpose,  is  in  a  state  of  constant 


WITH   THE    INSANE.  89 

nervous  irritation.  The  organs  of  the  body  most 
closely  related  to  mental  life  can  not  perform  their 
functions  properly.  The  condition  of  mind  corres- 
ponds to  the  condition  of  body.  Neither  has  a  nor- 
mal and  healthy  growth.  The  habit  of  rebellion 
becomes  chronic.  The  child  resists  the  authority  of 
home  and  the  school,  and  later  of  society  and  the 
state.  He  is  in  a  condition  of  perpetual  warfare. 
There  is  no  quiet  rest  of  nerve  or  brain,  and  no 
steady  action  of  the  intellect  or  moral  nature. 

Let  such  a  person  be  attacked  by  some  acute  disease, 
the  proper  treatment  of  which  requires  perfect  rest 
of  body  and  mind,  and  complete  submission  to  the 
directions  of  a  physician ;  and  the  chances  of  recovery 
are  seriously  lessened  by  his  character  and  habits. 
There  can  be  no  question  that  a  mind  permitted  to 
grow  up  in  this  way  is  more  liable  to  insanity,  and 
has  fewer  chances  of  recovery. 

(2)  Children  should  be  taught  self-control.  Self- 
control  is  more  than  simple  mastery  over  one's 
temper.  That  is  of  prime  importance,  but  it  is  only 
the  first  step.  That  must  be  acquired,  if  the 
child  is  to  have  a  well-balanced  mental  organ- 
ization. There  must  be  also  control  of  appetites, 
both  natural  and  acquired ;  control  of  all  the  passions  ; 
control  of  every  feeling ;  control  of  the  mental  powers ; 
in  a  word,  of  the  whole  being.  One  of  the  highest 
ends  of  education,  so  far  as  the  individual  himself  is 
concerned,  is  to  bring  every  power  and  faculty  into 


90  TWENTY-FIVE   YEARS 

perfect  submission  to  the  will.  Then  self-control  is 
fully  attained.  To  all  children,  but  especially  to 
those  of  nervous  and  highly  sensitive  organizations, 
the  proper  mastership  over  the  sensibilities  is  of  vital 
importance.  If  there  should  be  a  tendency  in  the 
nature  to  give  way  to  morbid  feelings,  to  "  brood  " 
over  things,  to  be  moody  and  capricious  and  irritable 
without  apparent  cause,  the  greatest  possible  care 
should  be  taken  to  counteract  this  tendency  by  wise 
methods.  With  such  an  inheritance,  the  beginnings 
of  positive  mental  disease  will  be  very  easily  made. 
Right  instruction  and  training  in  this  respect  by 
parents  and  teachers,  would  have  saved  many  of  the 
inmates  of  our  asylums  from  a  fate  worse  than  death. 
(3)  Moral  instruction  and  training  should  be  given. 
These  must  begin  in  the  home,  where  the  life  of  the 
child  begins.  The  school  must  second  and  carry 
forward  the  work  of  the  home.  Right  impulse  must 
be  given ;  the  seeds  of  right  habits  must  be  planted  ; 
sound  principles  must  be  inculcated.  Feelings  of 
duty  and  obligation  must  be  excited,  moral  judgment 
instructed,  and  conscience  quickened.  The  connec- 
tion between  the  moral  and  intellectual  natures  is  so 
intimate  that  disease  in  one  can  hardly  fail  to  be 
communicated  to  the  other.  It  is  doubtful  if  moral 
corruption,  in  certain  directions,  can  co-exist  with 
perfect  mental  health.  Certain  it  is  that  some  forms 
of  moral  pollution  and  degradation  are  precursors  or 
attendants  of  some  forms  of  mental  disease. 


WITH    THE    INSANE.  91 

(4)  Instruction  should  be  given  in  respect  to  the 
nature  and  effects  of  alcohol,  tobacco,  and  other  nar- 
cotics, both  in  the  home  and  in  all  institutions  of 
learning  where  pupils  are  old  enough  to  be  profited 
by  it.     The  relation  of  these  articles  to  insanity  has. 
been  discussed  elsewhere. 

(5)  In  institutions  of   higher  learning  instruction 
should  be  given  in  respect  to  the  action  of  mind, 
both  in  health  and  in  disease,  in  respect  to  the  rela- 
tion of  body  and  mind,  and  the  influence  of  the  one 
over  the  other.     The  importance  and  power  of  inher- 
ited tendencies  should  be  so  explained  and  illustrated 
ac  to  produce,  if  possible,  a  practical  effect  upon  con- 
duct, not  only  during  student-life,  but  subsequently 
in  a  business  or  professional  career,  and  in  the  forma- 
tion of  the  most  intimate  domestic  relations. 

(6)  Artificial  incitements  to  study,  such  as  prizes, 
etc.,  should  very  seldom,  if  ever,  be  employed.     I  am 
not  unaware  that  excellent  men  and  successful  in- 
structors hold  different  views.     None  the  less,  how- 
ever, I  have  a  deeply  rooted  conviction  that  such 
means   of  stimulating   the  activity  of   students   are 
open  to  the  most  serious  objections,  both  upon  moral 
and  mental  grounds.     The  moral  objections  are  not 
in   place  here.      Their  natural   influence  upon   the 
intellect  is  the  primary  consideration,  and,  as  neces- 
sarily related  to  this,  their  effect  upon  the  bodily 
health  and  vigor.     Referring  to  this  subject,  a  writer 
says, — 


92  TWENTY-FIVE  YEARS 

"Let  me  tell  you  what  I  have  seen  in  Christian  New  England. 
Two  brilliant,  high-hearted  youths,  the  rival  leaders  of  their 
class,  all  the  rest  left  behind,  stretching  across  the  four-years' 
course  neck  and  neck,  stimulated  by  the  spirit  of  an  eager  emu- 
lation, sacrificing  health  and  peace,  only  to  drop,  one  into  a  grave 
and  the  other  into  mental  perversion,  at  the  end  of  the  heat." 

This  is  an  extreme  case,  but  hardly  less  sad  ones 
can  be  found  in  every  asylum.  I  have  in  mind 
examples  of  hopeless  imbecility,  resulting  from  un- 
wise stimulation  of  faculties  precociously  developed, 
and  consequently  immature  and  unable  to  endure  the 
strain  of  steady  and  continued  effort.  In  almost  all 
such  cases  the  mental,  and  often  the  physical,  organ- 
ization is  defective  and  unstable.  Less,  and  not 
more,  than  the  usual  amount  of  intellectual  labor 
should  be  imposed  upon  children  of  this  sort.  Out- 
of-door  sports,  and  not  in-door  reading  and  study, 
should  be  prescribed  and  encouraged. 

In  primary  and  secondary  schools  any  system  of 
examinations  and  markings  which  causes  constant 
anxiety  and  strong  nervous  excitement,  on  the  part 
of  pupils  of  average  abilities  and  attainments,  is  to  be 
condemned,  and  ought  to  be  forthwith  abolished. 
Possibly  "  average  standings  "  may  be  lower,  though 
this  is  not  certain ;  but  the  average  health,  tone,  and 
spirits  of  scholars  will  be  vastly  higher. 

The  physical  and  mental  health  of  both  pupils  and 
teachers  will  be  kept  in  better  condition,  and  more 
work  of  real  value  will  be  accomplished,  if  school 
arrangements,  methods,  and  lessons  are  such  that  the 


WITH    THE    INSANE.  93 

school-room,  with  its  perplexities  and  tasks,  can  be 
wholly  forgotten  during  twelve  out  of  every  twenty- 
four  hours. 

It  is  unnecessary  to  say  that  I  have  little  sympathy 
with  the  indiscriminate  abuse  heaped  upon  schools 
and  teachers  by  some  writers  whose  knowledge  of  the 
actual  requirements  and  interior  workings  of  schools 
is  derived  from  hasty  casual  visits,  or  from  the  state- 
ments of  over-ambitious  scholars  returning  home 
with  "armfuls  of  books  and  bundles  of  papers"  cov- 
ered with  historical  questions  and  mathematical  prob- 
lems, or  from  the  stories  of  parents  whose  children 
are  suffering  from  evening  parties,  and  late  hours,  and 
unwholesome  diet,  more  than  from  school  tasks  and 
regulations.  I  arn  speaking  from  the  inside,  from  the 
teacher's  desk,  and  from  abundant  means  of  observa- 
tion. With  rare  exceptions,  it  is  not  overwork  by 
which  children  are  harmed.  The  evils  result  from 
the  unfavorable  conditions  under  which  the  work  is 
done  —  conditions  which  violate  the  laws  of  mental 
hygiene  as  well  as  of  common  sense.  The  friction  of 
an  ill-fitting  harness  exhausts  the  draught-horse  more 
than  a  heavy  load.  The  necessity  of  keeping  step 
with  those  whose  gait  is  altogether  unlike  our  own 
tires  more  than  the  walking.  Intellectual  gaits  differ 
as  widely  as  physical  ones. 

By  some  means  the  lower  schools  must  afford  more 
room  for  individuality,  both  in  teachers  and  scholars; 
personal  mental  peculiarities  should  receive  more 


94  TWENTY-FIVE  YEARS 

study  and  attention ;  less  value  should  be  attached  to 
the  results  of  stated  or  occasional  examinations,  and 
more  to  the  character  of  daily  work.  "The  acquisi- 
tion of  mental  power  is  more  to  be  desired  than  the 
acquisition  of  knowledge.  The  power  to  do  is  worth 
more  than  the  power  to  tell  what  others  have  done. 
The  ability  to  comprehend  and  apply  principles  out- 
ranks, in  practical  importance,  the  ability  to  remem- 
ber facts  and  repeat  them  in  chronological  order." 


CHAPTER  XII. 
RELIGION  AND   INSANITY. 

Among  the  assigned  causes  of  insanity  in  asylum 
reports  "religious  excitement"  appears.  Cases  of 
mental  disorder  classed  under  this  head  usually  have 
their  recognized  beginnings  in  close  connection  with 
those  seasons  of  special  religious  interest  and  activity 
called  "revivals."  A  peculiar  sensitiveness  in  regard 
to  cases  of  this  kind  exists  in  some  quarters.  A  dis- 
position is  manifested  occasionally  to  deny,  or  at  least 
to  doubt,  the  correctness  of  the  classification.  It 
seems  to  be  supposed  that,  in  some  way,  the  imputa- 
tion of  insanity  to  this  cause  casts  reproach  upon 
religion.  There  is  also,  on  the  part  of  those  who  reject 
certain  doctrines  and  disapprove  certain  methods,  an 
inclination  to  over-estimate  the  number  of  cases  thus 
produced,  and  to  exaggerate  the  evils  springing  from 


WITH  THE   INSANE.  95 

methods  which  they  condemn.  They  who  deny  too 
much  and  they  who  affirm  too  much  are,  so  far  as 
observation  enables  me  to  judge,  about  equally  in 
fault.  The  cause  of  truth  is  never  harmed  by  a  frank 
admission  of  well-established  facts,  nor  benefited  by 
the  assumption  as  authentic  of  that  which,  at  best,  is 
only  possible  or  probable. 

It  is  undeniable  that  attacks  of  violent  insanity 
can  be  directly  traced  to  so-called  "religious  excite- 
ment." It  is  equally  certain  that  such  cases  are 
infrequent.  Out  of  one  thousand  and  twenty  patients 
admitted  to  an  asylum,  eighteen  cases  were  attributed 
to  this  as  the  probable  exciting  cause.  In  some  insti- 
tutions the  percentage  will  be  greater,  in  others  less. 
It  is  only  an  act  of  justice  to  add  that  tables  of 
assigned  and  probable  causes  are  usually  very  un- 
satisfactory to  those  who  prepare  them.  Compara- 
tively few  attacks  of  insanity  are  due  to  a  single 
definite  cause.  More  frequently  the  disease  is  pro- 
duced by  a  combination  of  conditions  and  circum- 
stances, no  one  of  which  alone  would  have  brought 
about  the  result.  Some  of  the  causes  may  have  been 
in  operation,  entirely  unsuspected,  for  a  long  time. 
The  assigned  cause  may  be  merely  the  accidental 
occasion  of  the  final  outbreak.  This  is,  without 
doubt,  true  of  a  considerable  proportion  of  the  vic- 
tims of  so-called  religious  insanity. 

A  few  statistics  of  a  somewhat  general  character 
may  be  of  interest.  Up  to  the  time  when  four  hun- 


96  TWENTY-FIVE   YEARS 

dred  and  seventy-three  patients  had  been  received  into 
the  Michigan  Asylum,  just  about  one-half  were  mem- 
bers of  some  religious  organization.  Of  these  seventy- 
one  were  Methodists,  forty  were  Roman  Catholics, 
thirty-three  were  Presbyterians,  twenty-three  were 
Baptists,  twenty-one  were  Episcopalians,  nineteen 
were  Congregationalists,  six  were  Friends  (Quakers),  * 
five  were  Universalists,  and  the  remainder  were 
divided,  by  ones  and  twos,  among  various  other 
denominations.  As  would  naturally  be  expected,  a 
much  larger  proportion  of  females  than  of  males  were 
communicants  of  churches.  My  impression  is,  also, 
that  forms  of  insanity  which  would  be  called  religious 
are  relatively  more  frequent  among  women  than 
among  men.  This  would  be  anticipated  when  it  is 
remembered  that  the  emotional  element  is  stronger  in 
the  female  mind,  as  a  rule,  than  in  the  male. 

Both  the  records  of  asylums  and  personal  observa- 
tion will  justify  the  general  conclusion,  I  believe, 
that  no  one  recognized  form  of  religious  faith  can  be 
specially  charged  with  the  production  of  insanity. 
It  does  not  appear  that  the  members  of  one  church 
are  more  liable  to  attacks  of  mental  aberration  than 
members  of  any  other.  Nor  does  it  appear  that  the 
peculiar  doctrines  of  an  accepted  creed  exert  an 
appreciable  influence  upon  the  character  of  mental 
delusions. 

It  is  due,  however,  to  truth  to  say  that  individuals 
of  peculiarly  nervous  and  unstable  organizations  can 


WITH   THE   INSANE.  97 

not  safely  be  exposed  to  long-continued  excitement 
of  any  sort.  The  danger  will  be  still  greater  if  such 
an  unfortunate  organization  has  been  inherited.  Ex- 
haustion from  over-work,  from  disease,  from  loss  of 
sleep,  from  anxiety,  or  from  any  other  cause,  brings 
many  persons  into  a  most  critical  condition.  Under 
such  circumstances,  any  intense  excitement  may  des- 
troy the  mental  equilibrium  and  fatally  weaken  the 
power  of  self-control.  Undoubtedly  religious  truths 
are  calculated  to  stir  the  sensibilities  more  profoundly 
than  any  others.  These  truths  may  be,  and  some- 
times are,  so  presented  as  to  appeal  to  the  emotions 
and  the  imagination  more  than  to  the  judgment 
and  reason.  The  resulting  state,  of  both  body  and 
mind,  is  one  of  peculiar  danger  to  persons  of  delicate 
health  and  of  highly  nervous  temperament,  especially 
if  exhausted  by  labor  and  harassed  with  cares  and 
anxieties.  In  some  cases,  without  question,  insanity 
follows  —  insanity  which  might  probably  have  been 
avoided,  if  all  parties  concerned  had  possessed  more 
knowledge  and  exercised  more  judgment  and  pru- 
dence. Some  such  cases,  though  not  a  large  number, 
have  fallen  under  my  own  observation. 

The  spiritual  nature  is  so  closely  allied,  at  all 
points,  with  the  intellectual,  and  both  these  are  so 
intimately  associated  with  the  physical  organization, 
that  those  who  are  dealing  with  one  need  to  under- 
stand something,  at  least,  of  the  laws  which  govern 
the  others,  of  the  mutual  relations  between  them,  and 


98  TWENTY-FIVE   YEARS 

of  the  influence  exerted  by  each  over  the  others. 
Without  such  knowledge  the  religious  character  and 
condition  of  many  persons  can  not  be  justly  estimated, 
nor  can  they  be  wisely  advised  and  guided.  It  is 
clearly  the  duty  of  pastors  and  other  religious 
teachers  and  guides  to  become  acquainted  with  the 
whole  complex  nature  of  man,  and  to  study  also  the 
individual  characteristics  of  the  members  of  their 
churches  and  congregations.  It  is  a  deed  of  greater 
kindness  to  save  one  from  disease  than  to  heal  him 
after  he  has  been  attacked.  Limits  must  sometimes 
be  put  to  the  religious  exercises  and  labors  of  indi- 
viduals of  peculiarly  impressible  and  excitable  organ- 
izations. They  are  exposed  to  the  danger  of  being 
"  religious  overmuch  "  in  certain  directions,  a  danger 
from  which  men  in  general  are  entirely  free.  Such 
persons,  under  the  reaction  which  is  sure  to  follow 
too  protracted  and  exhaustive  labors,  even  for  the 
best  of  objects,  easily  fall  into  a  state  of  mental 
depression.  This  assumes  the  form  of  spiritual  de- 
pression and  darkness.  Light,  joy,  and  peace  are 
gone.  They  imagine  themselves  the  greatest  of 
sinners.  For  them  there  is  no  hope ;  they  are  beyond 
the  reach  of  mercy  or  love.  They  may  be  of  the 
purest  religious  character  and  of  spotless  lives,  may 
have  abounded  in  practical  good  works ;  —  all  this 
serves  to  increase,  rather  than  to  diminish,  the  crush- 
ing load  which  weighs  them  down.  They  affirm, 
with  the  utmost  sincerity,  that  their  whole  past  lives 


WITH   THE   INSANE.  99 

have  been  hollow,  meaningless  shams ;  that  they  have 
never  known  true  religion,  or,  if  they  have,  are  now 
fallen  below  the  possibility  of  recovery.  Only  the 
"  blackness  of  darkness  "  is  in  reserve  for  them. 

Now,  first  of  all,  in  dealing  with  such  cases,  the 
wise  friend  and  guide  will  enter  into  no  arguments  or 
reasonings.  The  border  line  between  sanity  and 
insanity  has  been  crossed.  These  present  manifesta- 
tions are  not  causes,  but  consequences,  of  disease. 
The  remaining  hope  is  that  the  delusion,  whose  hold 
may  not  yet  be  very  firmly  fixed,  can  be  shaken  off. 
Arguments,  by  keeping  the  attention  of  the  patient 
directed  toward  the  false  notion,  will  only  serve  to 
fasten  it  more  deeply  and  thoroughly  in  the  mind. 
The  current  of  thought  must  be  changed,  and  set 
running  in  some  other  direction.  Worldly  employ- 
ments will  be  better  than  spiritual  ones  for  this 
purpose.  Almost  any  other  conversation  will  be 
more  wholesome  than  religious  exhortations  or  con- 
solations in  this  morbid  condition.  Fitting  amuse- 
ments and  recreations  will  be  more  salutary  than 
fastings,  and  prayers,  and  self -examinations. 

The  following  extract,  from  a  long  letter  written  to 
me  by  a  restored  patient,  will  illustrate  the  danger  of 
which  I  have  spoken.  After  describing  some  con- 
ditions and  exercises  to  which  she  had  been  subjected 
for  a  considerable  time,  she  says: 

"But  this  state  of  things  did  not  long  continue.  One  morn- 
ing there  suddenly  fell  upon  me  a  trembling  consciousness  of 


100  TWENTY-FIVE   YEARS 

sin,  and  an  indefinable  fear  took  possession  of  me.  But  as  I 
stoutly  resisted  what  seemed  to  me  a  weak  and  unworthy  feeling, 
it  soon  passed  away,  to  return  in  a  few  hours  with  an  array  of 
terrors  that  could  not  be  allayed.  Suddenly  as  the  lightning 
illuminates  the  sky,  it  seemed  to  me  that  the  very  heavens  were 
opened,  and  I  saw  the  awful  majesty  of  God.  Involuntarily  I 
closed  my  eyes,  as  if  to  shut  out  the  terrible  brightness  of  the 
vision.  For  one  single  moment  my  whole  soul  was  drawn 
upward  in  aspirations  towards  that  unapproachable  holiness, 
but  the  next,  the  fearful  conviction  that  it  could  never  be,  that  I 
was  not  only  a  sinner,  but  the  very  chief  of  sinners,  rushed  upon 
me  with  such  crushing  weight  that  I  should  have  been  helplessly 
stricken  to  the  earth,  but  for  the  supporting  arms  of  those 
about  me.  I  gave  expression  to  my  mental  agony,  and  was 
pointed  by  a  single  Christian  friend  to  the  Saviour,  when  I  found, 
to  my  horror,  that  I  did  not  and  never  had  believed  in  his  ability 
to  save. 

"My  great  sufferings  threw  me  quickly  into  a  brain  fever, 
from  which  I  only  slowly  recovered  after  weeks  of  the  most 
painful  sickness,  and  such  mental  and  spiritual  conflict  as  I  pray 
God  I  may  never  know  again.  For  many  long  months  I  found 
no  spiritual  peace.  I  felt  myself  abandoned  of  God  and  man, 
secluded  myself  from  society,  and  gave  myself  up  to  remorse 
and  despair.  In  vain  I  prayed;  in  vain  I  wept  tears  of  bitter- 
ness; in  vain  I  listened  to  exhortations  and  prayers.  I  actually 
believed  that  God's  infinite  power  could  never  save  me,  his 
mercy  never  reach  me.  I  reasoned  that  God  could  never  love  me 
because  I  was  a  sinner,  and  it  was  his  nature  to  hate  what  was 
sinful  and  unholy.  It  is  not  my  purpose  to  recapitulate  all  the 
conflicts  through  which  I  passed,  the  long  and  painful  process  of 
reasoning  and  reading  through  which  I  at  last  became  convinced 
of  the  possibility  of  an  atonement;  for,  spite  of  my  education,  I 
now  saw  an  atonement  to  be  absolutely  requisite  even  for  the 
purest  saint,  much  more  for  such  a  rebel  as  I  felt  myself  to  be.  But 
I  did  believe  it  at  length,  intellectually  at  least;  but  yet  I  had 
gained  nothing,  for  this  Saviour,  loving  and  all-sufficient  as  he 


WITH  THE   INSANE.  101 

was,  could  avail  me  nothing.  I  was  all  sinfulness,  and  he  must 
everlastingly  hate  me. 

' '  But  there  came  a  change,  and  for  many  weeks  my  heart  was 
literally  burdened  with  a  sense  of  Christ's  love,  though  I  still 
felt  he  could  never  save  me  from  sin  and  misery.  I  felt  he  had 
waited  all  my  life  long  to  be  gracious,  and  was  finally  forced  to 
yield  to  the  overwhelming  consciousness  that,  despite  my  wicked 
heart,  he  could  make  me  loving  and  submissive;  and,  in  all 
humility,  I  gratefully  accepted  the  cup  of  salvation  from  his 
bountiful  hand. 

"But  my  periods  of  enjoyment  were  comparatively  brief, 
though  intensely  rapturous,  so  much  so  as  to  make  me  fear  that 
they  were  merely  the  excitement  of  highly  wrought  feelings. 
While  they  continued  I  could  not  doubt  their  genuineness,  but 
when  they  passed  away  I  grew  doubtful  and  rebellious.  After 
more  than  a  year  of  such  intense  suffering,  relieved  only  by  brief 
intervals  of  spiritual  exaltation,  I  was  again  attacked  with  brain 
fever,  during  which  I  lay  at  the  point  of  death  for  many  days, 
being  constantly  delirious,  and  was  left  in  a  state  of  confirmed 
insanity  which  was  not  relieved  until  after  I  came  to  the 
Asylum." 

It  is  more  than  probable  that  all  this  intense  suf- 
fering and  many  long  months  of  almost  hopeless 
insanity  might  have  been  prevented,  if  parents  and 
teachers  and  spiritual  guides  had  understood  better 
the  laws  of  physical  and  mental  and  religious  life. 

A  singular  phenomenon  presents  itself  in  some 
cases  of  mental  disease.  The  delusion  under  which 
a  patient  labors  is  of  a  religious  or  a  semi-religious 
character,  although  the  previous  life  has  not  been  in 
any  respect,  not  even  by  profession,  religious;  nor 
has  the  mind  of  the  person,  so  far  as  can  be  ascer- 
tained, ever  been  specially  inclined  to  dwell  upon 


102  TWENTY-FIVE   YEARS 

religious  subjects.  I  recall  a  stout  and  somewhat 
florid  gentleman,  whose  life,  as  I  understood,  had  not 
been  remarkable  for  piety  or  regularity,  who  often 
insisted  on  removing  his  garments  so  as  to  allow  me 
to  examine  the  scar  remaining  from  the  wound 
inflicted  by  the  spear  of  the  Eoman  soldier.  At  one 
time  two  gentlemen,  each  of  whom  believed  himself 
to  be  possessed  of  supreme  power,  were  associated 
upon  the  same  ward  of  the  asylum.  Neither  of  these 
patients,  as  appeared  by  the  history  of  their  cases,  had 
been  distinguished  for  reverence  and  regard  for  the 
Deity.  One  unacquainted  with  the  vagaries  of  the 
insane  would  naturally  conclude  that  delusions  of 
this  sort  must  have  their  origin  in  religious  causes. 
No  conclusion  could  be  farther  from  the  truth.  The 
notions  upon  which  the  mind  fastens  in  its  unbal- 
anced condition  seem  to  have  as  little  relation  to  the 
ideas  of  the  previous  sane  state  as  dreams  have  to  the 
every-day  occurrences  of  waking  life.  Some  occult 
law  may  act  in  both  cases,  but  no  such  law  has  yet 
been  discovered. 

Not  unfrequently  the  moral  nature  appears  to  be 
completely  changed  by  an  attack  of  mental  disease. 
Persons,  even  ladies,  who  have  been  above  all 
reproach,  pure  in  deed  and  word  and  thought,  become 
offensive  in  conduct,  and  profane  and  vulgar  in 
speech.  Modesty,  piety,  and  good  taste  seem  to  have 
been  wiped  out  of  the  soul  for  the  time.  Though 
deeply  and  profoundly  religious  when  in  health, 


WITH  THE   INSANE.  103 

every  vestige  of  religious  faith  and  character  van- 
ishes. No  connection,  so  far  as  I  know,  can  be 
traced  between  these  abnormal  manifestations  and 
the  causes  of  insanity.  As  in  the  cases  previously 
mentioned,  the  insane  condition  furnishes  but  little 
indication  of  the  original  disposition,  temper,  training, 
or  habits.  It  would  be  quite  possible  for  "religious 
excitement "  or  intellectual  over- work  to  be  followed 
by  mental  disorder  of  a  gross  and  repulsive  form. 
Such  facts  have  to  be  borne  in  remembrance  when 
considering  cases  of  so-called  religious  insanity. 

Leaving  aside  peculiar  and  exceptional  cases,  I  am 
confident  that  an  intelligent  religious  faith  tends  to 
preserve  mental  health,  and,  when  this  health  has 
been  impaired,  helps  the  process  of  restoration.  A 
firm  belief  in  a  wise  and  just  and  good  over-ruling 
Power,  who  can  be  trusted  and  loved,  even  though 
his  ways  are  sometimes  "  past  finding  out,"  gives  to 
the  weakened  and  trembling  mind  a  much-needed 
resting-place.  A  consciousness  of  the  presence  and 
personal  friendship  of  this  Divine  Being  supplies  a 
haven  of  refuge  when  alarms,  confusions,  and  anxie- 
ties come  in  to  annoy  and  disturb.  The  testimony  of 
not  a  few  restored  patients  has  served  to  confirm  my 
confidence  in  the  healing  power  of  true  religion. 


104  TWENTY-FIVE   YEARS 


CHAPTER  XIII. 
ALCOHOL   AND   INSANITY. 

If  one  were  seriously  to  affirm  that  he  had  some- 
thing new  to  say  of  alcohol  and  its  influence  upon 
human  society,  he  would  expose  himself  to  the  sus- 
picion of  laboring  under  a  mental  delusion.  The 
subject  has  been  discussed  apparently  in  all  its 
aspects.  If  any  good  comes,  or  can  come,  from  the 
use  of  alcohol,  it  is  safe  to  conclude  that  somebody 
has  discovered  and  made  it  known.  The  catalogue 
of  evils  with  which  it  stands  charged  is  already  so 
long  and  so  fearful  that  the  addition  of  another  to  the 
list  would  hardly  be  noticed.  I  am  not  so  presumpt- 
uous as  to  expect  to  make  such  addition,  or  to  darken 
the  shadows  in  the  picture  of  human  woes  produced 
by  the  use  of  intoxicating  liquors. 

The  mind  is  so  constituted,  however,  that  some 
truths  have  to  be  impressed  upon  it,  or  thoroughly 
fastened  in  it,  by  dint  of  repetition.  This  is  espe- 
cially the  case  when  appetite  and  passion  stand 
opposed  to  judgment  and  reason,  and  when  gratifica- 
tion is  immediate  and  evil  consequences  are  remote 
and  partially  hidden.  Besides,  new  members  of 
society  are  constantly  taking  their  places  upon  the 
stage  of  human  activity,  and  children  do  not  inherit 
the  wisdom  of  their  parents.  At  best  they  only 


WITH   THE   INSANE.  105 

receive  by  transmission  the  capacity  and  disposition 
to  learn.  They  must  be  taught  the  same  lessons 
which  have  been  already  taught  over  and  over  again. 
Just  here  many  most  excellent  and  zealous  reformers 
and  other  good  people  fall  into  a  natural  but  unfor- 
tunate fallacy.  They  declare  that  certain  things  "  are 
settled."  But  the  fact  is,  however  much  we  may 
regret  it,  that  nothing  is  ever  finally  and  perma- 
nently settled  which  has  its  basis  in  the  deductions  of 
reason,  or  in  conclusions  drawn  from  experiment,  so 
long  as  every  man  does  his  own  reasoning  and  makes 
his  own  experiments.  Things  which  depend  upon 
instinct,  upon  intuition,  and  upon  authority,  may  be 
settled  ;  but  authority  must  be  uniform  and  absolute, 
or  it  goes  for  nothing. 

The  war  against  alcohol  and  its  brood  of  evils  and 
horrors  will  consequently  have  to  go  on,  and  be 
fought  over  with  each  successive  generation,  unless 
human  nature  shall  meet  with  some  happy  transfor- 
mation. The  greed  of  appetite  and  the  greed  of  gain 
are  mighty  forces,  and  are  alike  deaf  to  the  appeals  of 
reason.  Men  will  continue  to  manufacture  and  sell, 
and  other  men  will  continue  to  drink  alcohol  in  vari- 
ous forms,  though  every  draught  helps  to  produce 
idiocy,  insanity,  and  murder. 

Statistics  prove,  beyond  all  reasonable  doubt,  that 
intemperance  is  one  of  the  prolific  causes  of  mental 
disease.  Its  work,  however,  is  largely  indirect,  and 
is  not  to  be  estimated  by  the  number  of  inebriates 


106  TWENTY-FIVE  YEARS 

committed,  during  any  given  period,  to  asylums  for 
the  insane.  Alcohol  poisons  the  blood  and  corrupts 
the  very  fountain  of  life.  The  drunkard  transmits  to 
his  posterity  woes  from  which  premature  death  may 
kindly  relieve  him.  Yet  the  cases  of  disease  caused 
directly  are  very  numerous.  Dr.  Take,  in  speaking 
of  insanity  among  the  laboring  classes  in  England, 
says,  "Among  the  causes,  intemperance  unmistakably 
takes  the  lead."  In  France  the  consumption  of  alcohol 
doubled  from  1849  to  1869.  During  the  same  period 
mental  disease  increased  fifty-nine  per  cent,  among 
men,  and  fifty-two  per  cent,  among  women.  A  larger 
part  of  this  increase  could  be  traced  pretty  directly  to 
the  increased  use  of  alcohol.  At  the  Worcester  asy- 
lum nineteen  per  cent,  of  the  admissions  were 
charged  to  intemperance  during  four  years,  when  the 
habit  of  drinking  liquor  was  very  general.  During 
four  years  when  the  temperance  movement  was  at  its 
greatest  height,  only  four  per  cent,  were  due  to  this 
cause. 

Dr.  Stearns  states  that  more  than  ten  per  cent  of 
5000  cases  in  the  Hartford  Retreat  were  caused  by 
the  use  of  alcohol,  without  including  cases  of  inher- 
ited tendency  produced  by  the  habits  of  parents.  In 
all  asylums  cases  of  the  latter  sort  are  much  more 
numerous  than  those  attributed  directly  to  intemper- 
ance. If  to  the  cases  caused  directly  and  by  inheri- 
tance we  add  the  cases  produced  by  want,  by  over- 
work, by  sufferings  both  of  body  and  mind  among  the 


WITH  THE   INSANE.  107 

families  and  friends  of  drunkards,  certainly  one 
fourth,  and  probably  fully  one  third,  of  all  the  insan- 
ity in  the  country  must  be  charged  to  alcohol.  I  do 
not  include  in  this  statement  cases  of  idiocy  and 
imbecility,  of  which  it  is,  without  question,  the  most 
prolific  cause. 

If  zeal  which  outruns  judgment  is  ever  excusable, 
or  even  rises  to  the  rank  of  a  virtue,  it  is  when  the 
question  of  dealing  with  the  production,  sale,  and  use 
of  intoxicating  liquors  is  under  consideration.  What 
to  do  about  the  traffic  in  such  liquors,  and  their  use 
as  beverages,  is  the  great  problem  of  our  age,  and  its 
solution  requires  all  the  practical  wisdom  of  statesmen 
and  philanthropists.  The  question  is  too  broad  and 
deep  to  be  "  settled  "  by  narrow  partisanship  or  angry 
denunciation.  Genuine  humanity  and  sound  political 
economy  must  join  in  the  final  solution.  Meanwhile 
a  great  work  of  education  is  to  be  done  for  and  upon 
the  young  in  our  homes  and  in  the  schools.  The 
nature  of  alcohol  and  its  effects,  both  upon  the 
drinker  and  upon  his  offspring,  must  be  thoroughly 
taught,  as  well  as  the  enormous  taxation  which  it 
inflicts  upon  society.  It  will  not  be  sufficient  simply 
to  give  instruction.  Knowledge  is  not  all,  or  even 
the  most,  that  is  needed.  The  moral  nature  of  the 
growing  citizen  must  be  reached  and  enlightened.  A 
feeling  of  responsibility  must  be  excited  and  prop- 
erly directed.  It  may  as  well  be  frankly  admitted 
that  mere  intellectual  education  does  not  arm  men 


108  TWENTY-FIVE   YEARS 

with  the  power  and  disposition  to  resist  the  cravings 
of  appetite,  or  the  seductive  influence  of  supposed 
self-interest.  If  experience  ever  settles  anything, 
that  has  been  finally  decided  by  the  results  of  the 
education  of  the  last  half-century.  The  springs  of 
human  action  lie  either  above  or  below  the  intellect 
—  either  above  in  the  moral  and  religious  nature,  or 
below  among  the  appetites  and  passions.  If  the 
higher  nature  is  not  developed,  strengthened,  and 
directed,  the  lower  will  be  certain  to  secure  the  mas- 
tery, in  spite  of  the  veneering  and  polish  which  come 
of  the  culture  of  intellect  and  taste.  If  public  senti- 
ment will  not  tolerate  moral  instruction  in  the  public 
schools,  and  if  teachers  are  not  prepared  to  give  and 
enforce  such  instruction,  both  by  principle  and  con- 
duct, then  text-books  on  the  "Effects  of  Alcohol  and 
Narcotics  upon  the  Human  System,"  though  approved- 
by  all  the  "Boards"  in  the  State,  will  have  little 
practical  value.  Children,  and  those  older  than 
children,  must,  if  they  are  to  be  moved  to  action,  not 
only  know  that  a  specific  indulgence  of  appetite  or  a 
certain  course  of  life  results  in  bodilv  harm  arid  loss. 

•/ 

but  they  must  also  feel  that  the  indulgence  and 
course  of  life  involve  moral  responsibility  and  guilt. 
Charles  Lamb,  writing  out  of  his  own  bitter  expe- 
rience, says,  "  Could  the  youth,  to  whom  the  flavor  of 
his  first  wine  is  delicious,  look  into  my  desolation, 
and  be  made  to  understand  what  a  dreary  thing  it  is 
when  a  man  feels  himself  going  down  a  precipice 


WITH  THE   INSANE.  109 

with  open  eyes  and  a  passive  will, —  to  see  his 
destruction  and  to  have  no  power  to  stop  it,  and  yet 
to  feel  it,  all  the  way,  emanating  from  himself;  to 
perceive  all  goodness  emptied  out  of  him,  and  yet 
not  to  be  able  to  forget  a  time  when  it  was  otherwise, 

—  to  bear  about  the  piteous  spectacle  of  self-ruin," 
he     might     be     saved     from      entering     upon     the 
downward    path.      In    this    extract  Lamb    touches 
the    core    of    the    matter.       Alcohol    destroys    the 
power    of    the    will,    and    thus  destroys    the    vital 
essence  of  all  true  manhood.     Of  the  confirmed  ine- 
briate there  is  little  hope :  the  foundation  is  terribly 
shattered,  if  not  absolutely  swept  away.     "  When  he 
would  do  good,   evil   is   present   with  him."     He  is 
wretched,  and  is  an  object  of  pity.   But  he  is  also  guilty 

—  guilty  of  slow  and  deliberate  suicide.     Humanity, 
religion,  patriotism  bid  us,  by  all  possible  means, 
save  the  young  —  save  them  from  dishonor,  degrada- 
tion, crime,  insanity,  idiocy. 


CHAPTER  XIV. 
TOBACCO   AND   OTHER  NARCOTICS  AND   INSANITY. 

The  consumption  of  tobacco  has  gone  on  steadily 
increasing  for  many  years.  Old  men  and  young  men 
use  it;  boys,  and  even  children,  use  it  Clergymen, 
lawyers,  doctors,  teachers  —  indeed,  "  all  sorts  and  con- 
ditions "  of  people  unite  in  worshiping  at  the  shrine  of 


110  TWENTY-FIVE   YEAKS 

"the  weed."  It  is  chewed,  and  smoked,  and  snuffed. 
It  is  presented  in  forms  enticing  and  forms  disgusting. 

Kecent  investigations  have  proved  that  a  considera- 
ble portion  of  the  boys  in  many  of  our  public  and 
other  schools  use  tobacco  either  habitually  or  occasion- 
ally. In  some  schools  fully  forty  per  cent  have  begun 
to  acquire  the  habit  of  either  chewing  or  smoking.  In 
not  a  few  cases  they  commence  the  practice  as  early  as 
at  eight  years  of  age. 

It  produces  little  effect  to  declaim  against  this  use  of 
tobacco  on  moral  or  economical  grounds.  To  say  that 
the  habit  is  offensive  and  filthy  is  only  repeating  what 
has  been  reiterated  a  thousand  times  to  no  purpose. 
If  this  pernicious  habit  is  to  be  checked,  other  consid- 
erations and  arguments  must  be  employed ;  and  it  is  a 
hopeful  omen  that  the  influence  of  tobacco  upon  the 
physical  organism  is  beginning  to  attract  serious 
attention. 

Its  immediate  effects  upon  one  not  habituated  to  its 
uses  are  well  known.  "A  biting  sensation,  more  or 
less  marked,  in  the  mucous  membrane  of  the  mouth, 
tongue,  and  throat,  a  feeling  of  warmth  and  faintness, 
nausea,  vomiting,  and  headache,  presently  a  coolness 
of  the  skin,  perspiration  on  the  forehead,  hurried  res- 
piration, and  feeble  action  of  the  heart,"  are  symptoms 
familiar  to  observation  and  experience.  It  is  well 
established  that  the  nicotine  of  tobacco,  one  of  the 
most  active  of  poisons,  acts  directly  upon  the  brain  and 
nervous  system,  producing  at  first  a  partial  paralysis. 


WITH   THE   INSANE.  Ill 

Fortunately,  or  perhaps  unfortunately,  for  the  physi- 
cal vigor  of  the  race,  the  system  in  maturity  has 
power  to  adjust  itself  to  this  poison,  and  the  peculiar 
effects  just  alluded  to  soon  cease  to  appear.  In  place 
of  these  a  soothing  and  pleasing  influence  is  felt,  which 
probably  comes  from  a  very  slight  paralysis  of  the 
nerves,  just  sufficient  to  allay  the  sense  of  discomfort 
and  irritation  produced  by  exhaustion  or  other  causes. 
The  power  of  resistance  and  adjustment  is  so  great  in 
the  adult  body  that  the  moderate  use  of  tobacco  may 
be  continued  for  a  long  time  with  little  observable 
harm.  The  excessive  use,  even  in  the  adult,  soon 
yields  a  prolific  harvest  of  evil ;  and  the  poor  victim 
of  artificial  appetite  is  compelled  to  choose  between  the 
pain  of  breaking  off  a  habit  not  easily  broken  and  pre- 
mature death,  or  physical,  if  not  mental,  imbecility. 

It  is  hardly  possible  to  exaggerate  the  pernicious 
effects  of  the  constant  use  of  tobacco  upon  the  young. 
The 'immature  brain,  nerves,  and  muscles  have  little 
power  of  resistance  or  adjustment  The  inevitable 
consequence  is  that  the  organs  of  the  body  do  not 
attain  their  normal  growth  or  reach  a  vigorous  matur- 
ity. The  boy  who  commences  the  habitual  use  of 
tobacco  in  any  form  &t  eight  years  of  age,  never 
becomes  the  man  he  might  have  been.  His  vitality 
has  been  sapped  and  weakened.  The  result  is  a  gen- 
eral flabbiness,  to  employ  a  word  more  expressive  than 
elegant,  of  the  whole  man,  mental  and  moral  as  well  as 
physical  Both  the  intellectual  and  moral  powers  are 


112  TWENTY-FIVE   YEARS 

less   active,  keen,  and   sensitive,   than  they  otherwise 
would  have  been. 

So  thoroughly  has  this  been  proved  that  in  France 
and  Germany  legal  enactments  have  been  made  forbid- 
ding the  use  of  tobacco  by  pupils  in  many  of  their 
schools.  During  some  years  its  use  has  not  been 
allowed  in  the  naval  and  military  schools  of  the  United 
States.  To  say  nothing  of  individual  welfare,  the  pub- 
lic interests  demand  that  effectual  restrictions  be  put 
upon  the  sale  of  tobacco,  in  any  form,  to  young  boysr 
and  that  some  effectual  means  be  devised  to  prevent 
its  use  by  the  pupils  in  our  public  schools.  It  is  not 
so  much  a  question  of  morals  as  of  manhood ;  patriot- 
ism is  as  much  concerned  as  purity;  the  State  has  a 
deeper  interest  than  even  the  family.  It  is  time,  cer- 
tainly, that  the  pulpit  and  the  desk,  the  preacher  and 
the  teacher,  were  purified  from  the  sight  and  smell  of 
tobacco;  if  not  for  moral  and  religious  considerations, 
then  for  the  sake  of  physical  manhood  and  political 
economy. 

It  is  not  claimed  that  the  use  of  tobacco  is,  in  any 
large  number  of  cases,  the  direct  cause  of  insanity. 
Indirectly,  and  associated  with  other  causes,  it  is  respon- 
sible for  much  mental  as  well  as  physical  suffering. 
It  inflicts  its  harm,  chiefly,  by  preventing  the  proper 
maturing  of  the  system,  especially  the  nervous  system, 
and  by  reducing  its  tone  and  vigor,  and  thus  exposing 
it,  with  weakened  powers  of  defense,  to  the  attacks  of 
other  enemies.  While  it  may  not,  to  any  considerable 


WITH  THE   INSANE.  118 

extent,  directly  originate  mental  disease,  it  certainly 
breaks  down  the  barriers,  opens  the  doors,  and  invites 
such  disease  to  enter,  and  makes  its  progress  more  easy, 
sure,  and  deadly.  It  acts  the  part  of  a  pretended 
friend,  who  does  not,  indeed,  set  fire  to  your  house,  but 
who  does  surreptitiously  remove  all  means  of  extin- 
guishing the  flames. 

Moreover,  by  the  laws  of  heredity,  the  effects  of  the 
habitual  use  of  tobacco  go  beyond  the  immediate  vic- 
tim and  the  present  generation,  and  entail  a  load  of  ills 
and  a  possible  burden  of  woes  upon  posterity.  An 
unstable  physical  and  mental  organization  is  a  sad 
patrimony  to  bequeath  to  one's  children,  and  a  fearful 
price  to  pay  for  a  little  temporary  gratification  of  an 
unnatural  appetite. 

While  speaking  thus  plainly  and  emphatically  of  the 
evils  resulting  from  the  habitual  use  of  tobacco,  more 
particularly  to  the  young,  I  wish  to  guard  against  a 
possible  misapprehension.  Nothing  is  gained,  even  to 
a  good  cause,  by  exaggeration.  The  harmful  effects  of 

*         *J 

tobacco  are  bad  enough,  are  surely  alarming,  but  they 
are  not  to  be  compared  to  those  resulting  from  the  use 
of  alcohol.  It  is,  in  my  opinion,  most  unwise  to  con- 
fuse and  mislead  by  denouncing  both  with  equal  zeal 
and  violence.  Alcohol  has  no  peer  in  capacity  and 
power  to  work  damage  to  all  the  interests  of  humanity. 
Intemperance  begets  and  perpetuates  a  greater  and 
more  hideous  brood  of  human  ills  than  any  other 
habit,  unless  it  be  that  of  sexual  license  and  impurity. 


114  TWENTY-FIVE  YEARS 

Between  the  offspring  of  these  kindred  monsters  a 
choice  would  be  difficult  Let  them  enjoy  their  unen- 
viable pre-eminence. 

Of  other  narcotics  opium,  of  which  morphine  is  the 
most  essential  principle,  is  the  most  common  and  the 
most  important  in  its  relations  to  mental  disease.  In 
limited  quantities  and  under  certain  conditions,  opium 
and  morphine  produce  a  species  of  enticing  and  pleas- 
urable intoxication.  The  eater  or  smoker  revels  in 
delightful  day-dreams  and  wondrous  flights  of  fancy. 
But  the  "opium  habit"  is  of  the  most  dangerous  char- 
acter. It  is  seductive,  alluring,  and  fascinating.  It 
seems  to  cast  a  fatal  spell  over  its  victim,  and  drags 
him  slowly,  but  steadily  and  surely,  down  to  degrada- 
tion and  ruin,  physical,  intellectual,  and  moral  The 
power  of  self-control  and  self-direction  is  soon  lost,  and 
the  ability  to  resist  the  raging  demands  of  unnatural 
appetite  utterly  disappears.  The  natural  sensibilities 
are  blunted,  and  moral  distinctions  gradually  fade 
away.  The  habitual  user  of  opium  becomes  a  pitiable 
wreck,  driven  hither  and  thither  by  the  demon  which 
he  has  himself  evoked 

Samuel  Taylor  Coleridge  affords  an  illustrious  exam- 
ple of  the  depth  of  misery  and  helplessness  into  which 
a  man  may  be  plunged  by  this  terrible  habit.  For 
fifteen  years  he  is  reported  to  have  been  its  slave.  He 
made,  De  Quincey  says,  "prodigious  efforts  to  deliver 
himself  from  this  thraldom;  and  went  so  far,  at  one 
time,  as  to  hire  a  man  for  the  express  purpose,  and 


WITH  THE   INSANE.  115 

armed  with  the  power  of  resolutely  interposing  between 
himself  and  the  door  of  any  druggist's  shop."  A  con- 
test actually  took  place  between  Coleridge  and  this 
"external  conscience,"  who  proved  faithful  to  his  trust 
What  an  abdication  of  all  manhood  is  indicated  by 
such  a  condition!  And  yet  Coleridge,  when  master 
of  himself,  was  one  of  the  most  brilliant  men  of  his 
time.  Saddest  of  all,  his  son  Hartley  inherited  the 
weakness  of  the  father,  and  wasted  life,  as  he  himself 
says,  "in  the  woful  impotence  of  weak  resolve." 

The  use  of  opium  in  some  form  is  said  to  have  greatly 
increased  in  this  country  within  the  last  few  years. 
The  importation  in  1881  was  85,075  pounds;  in  1883 
it  amounted  to  298,152  pounds.  The  "opium  habit" 
is  probably  more  common  among  women  than  among 
men,  though  it  is  not  by  any  means  confined  to  females. 
A  druggist  in  one  of  our  cities  is  reported  to  have  said, 
"  Hundreds  of  ladies  belonging  to  the  best  families  in 
the  city  are  addicted  to  the  habit,  but  the  number  of 
men  is  comparatively  small."  It  is  to  be  hoped  that 
this  is  a  libel  upon  the  women  of  that  city.  If  true, 
the  accommodations  for  imbeciles  will  need  to  be  greatly 
enlarged  in  our  asylums  at  an  early  day.  The  quan- 
tity of  morphine  taken  by  persons  long  accustomed  to 
its  use  is  almost  incredible.  A  dealer  in  drugs  states, 
"  There  are  women  in  this  city  who  take  enough  mor- 
phine in  a  day  to  kill  half  a  dozen  people  unac- 
customed to  it.  I  have  in  mind  a  lady  who  began 
coming  to  my  store  about  five  years  ago.  She  began 


116  TWENTY-FIVE  YEARS 

buying  packages  of  fifty  cents'  worth.  She  is  now  an 
imbecile,  and  consumes  ten  dollars'  worth  in  two 
months.  There  is  -no  such  thing  as  a  maximum  dose. 
There  are  numbers  of  frail  women  among  my  customers, 
each  of  whom  can  take  enough  morphine  at  one  dose 
to  kill  the  strongest  man  in  the  city." 

Such  excessive  indulgence  brings  loss  of  regular  and 
natural  appetite,  derangement  of  the  organs  of  diges- 
tion, torpor  of  the  intellectual  and  moral  faculties,  hal- 
lucinations, and  confirmed  and  degrading  disease  of 
both  body  and  mind.  If  the  use  of  this  drug  contin- 
ues to  increase,  it  will  obviously  be  the  duty  of  the 
civil  authorities  to  interfere,  in  some  vigorous  way, 
with  its  importation  and  sale.  The  duty  of  parents, 
teachers,  and  others  who  understand  the  use  and  influ- 
ence of  opium,  is  sufficiently  clear.  The  young,  the 
weak,  and  the  ignorant  are  entitled  to  protection  from 
the  danger  of  contracting  a  habit  whose  evil  influence 
can  hardly  be  over-estimated. 


CHAPTER  XV. 

INHERITED    TENDENCIES  AND   INSANITY. 

Among  my  acquaintances  and  friends  are  several 
excellent  persons  who  live  constantly  under  a  dark 
shadow.  In  some  cases  a  parent,  in  other  cases  a  more 
remote  ancestor,  suffered  from  insanity,  perhaps  died 
in  an  asylum.  They  have  read  the  recent  discussions 


WITH  THE   INSANE.  117 

upon  "heredity"  and  "environment,"  and  are  fully 
persuaded  that  they  are  cursed  with  a  fatal  inheritance. 
This  idea  disquiets  them  by  day  and  haunts  them  by 
night.  It  is  like  a  perpetual  nightmare  or  an  ever- 
present  skeleton.  It  tends  to  destroy  happiness,  to 
paralyze  energy,  and,  worst  of  all,  to  bring  upon  them 
the  very  evil  which  they  so  much  dread.  If  possible, 
I  should  be  glad  to  present  some  considerations  which 
might  help  to  dispel  the  shadow  that  hangs  over  indi- 
viduals of  this  class.  More  than  anything  else,  they 
need  courage  and  grounds  upon  which  to  predicate  a 
reasonable  hope  of  escaping  the  fate  impending,  as  they 
believe,  over  them. 

Upon  this  subject  of  transmitted  and  inherited  ten- 
dencies no  one  except  a  specialist  is  qualified  to  speak 
with  authority.  I  shall  not  presume  to  place  any 
reliance  upon  the  lessons  of  my  own  observation  in  a 
matter  of  this  sort.  I  shall,  therefore,  borrow  freely 
and  literally  the  opinions  of  those  who  are  competent 
to  instruct. 

The  doctrine  of  heredity,  in  its  general  form,  is  not 
new.  A  law  has  always  been  recognized  "by  which 
all  beings  endowed  with  life  tend  to  repeat  themselves 
in  their  descendants."  It  is  not  a  recent  discovery 
that,  "in  transmitting  the  germ  of  life,  parents  trans- 
mit to  their  children  their  own  resemblance,  physical, 
mental,  and  moral;  the  children  are  a  part  of  our- 
selves; it  is  our  flesh,  our  blood,  our  souls,  our 
examples,  our  lessons,  our  passions,  which  relive  in 


118  TWENTY-FIVE  YEARS 

them."  Physical  features  reappear  generation  after 
generation.  Intellectual  peculiarities  live  on  through 
many  successive  fathers  and  sons.  Moral  traits  appear 
over  and  over  again.  Deformities,  weaknesses,  idiosyn- 
crasies, and  morbid  tendencies  are  also,  by  the  same 
law,  transmitted.  All  these  facts  have  been  understood 
for  ages  by  intelligent. observers.  Cultivators  of  plants 
and  breeders  of  animals  have  turned  such  knowledge 
to  profitable  account  They  have  learned  that  even 
special  and  apparently  accidental  variations  from  the 
normal  type  may  also  be  transmitted  and  rendered 
more  or  less  permanent  by  the  law  of  inheritance. 

Recently,  however,  there  has  been  a  tendency  on  the 
part  of  writers  upon  "social  science"  to  attach  more 
importance  to  the  law  of  heredity  in  its  applications  to 
the  human  race,  and  to  emphasize,  if  not  to  exaggerate, 
its  influence.  The  purpose  which  these  authors  de- 
sired to  accomplish  was  a  laudable  one,  and  one  to 
which  the  public  mind  needed  to  be  directed.  They 
have  abundantly  proved  that  diseased  tendencies  of 
the  worst  description  are  propagated  from  parents  to 
children,  and  that  by  this  means  the  most  fearful 
evils  are  constantly  and  rapidly  increasing.  It  has 
been  shown,  beyond  all  question,  that  the  drunkard, 
whether  habitual  or  only  occasional,  entails  upon  his 
posterity  an  inheritance  of  woes  positively  frightful  to 
contemplate.  In  no  other  disease  are  the  hereditary 
influences  so  fatally  sure  as  in  alcoholism. 

Dr.  Morel  says : 


WITH  THE  INSANE.  119 

' '  Defective  nerve-power  and  an  enfeebled,  debilitated  morale 
form  the  favorite  legacy  of  inebriates  to  their  offspring.  Some  of 
the  circle,  generally  the  daughters,  may  be  nervous  and  hysteri- 
cal; others,  generally  sons,  are  apt  to  be  feeble  and  eccentric, 
and  to  fall  into  insanity  when  an  unusual  emergency  takes  place. 
That  the  impairment  of  the  bodily  or  mental  faculties  arises  from 
intemperance  of  one  or  both  heads  of  the  family  is  demonstrated 
by  the  healthfulness  and  intellectual  vigor  of  the  children  born 
while  the  parents  were  temperate,  contrasted  with  the  sickliness 
and  mental  feebleness  of  their  brothers  and  sisters  born  after  the 
parent  or  parents  became  intemperate.  The  most  distressing 
aspect  of  the  heredity  of  alcohol  is  the  transmitted  narcotic  or 
insatiable  craving  for  drink, —  the  dipsomania  of  the  physician, — 
which  is  every  day  becoming  more  and  more  prevalent." 

It  is  stated  upon  apparently  .good  authority  that 
"the  records  of  asylums  all  indicate  that  the  tendency 
to  insanity,  in  some  of  its  forms,  is  one  of  those  most  likely 
to  be  inherited.  It  is  thought  that  more  than  one  half 
of  the  admissions  to  English  asylums  present  evidence 
of  an  inherited  taint  The  same  is  probably  true  in 
reference  to  admissions  to  asylums  in  the  United 
States." 

It  would  be  strange  if  statements  of  this  kind, 
fortified  by  statistics  of  the  most  formidable  character, 
and  left  without  explanation  or  qualification,  did  not 
produce  a  deep  and  depressing  influence  upon  the 
minds  of  those  who  have  reason  to  suppose  such  a 
taint  to  run  in  their  blood. 

This  depressing  effect  is  deepened  by  the  further 
application  of  the  doctrine  of  heredity  to  the  depraved, 
vicious,  and  criminal  classes.  Transmitted  tendencies 


120  TWENTY-FIVE  YEARS 

and  environment  are  made  responsible  for  a  very  large 
percentage  of  all  violations  of  law  and  order.  Theft 
and  robbery,  assault  and  murder,  larceny  and  lechery, 
flow  concealed  in  the  veins,  and  only  wait  provocation 
and  opportunity  to  make  themselves  manifest. 

Undoubtedly  there  is  a  large  measure  of  truth  in  this 
view,  enough  to  demand  for  it  the  careful  consideration 
of  the  law-making  and  law-administering  powers,  as 
well  as  of  the  common  citizen  and  practical  philan- 
thropist. But  it  is  quite  possible  to  draw  from  this 
doctrine  deductions  and  inferences  of  the  most  unfor- 
tunate and  harmful  nature.  Man  may  be  reduced  to  a 
mere  automaton,  impelled  to  act  by  forces  over  which 
he  has  no  control,  the  mere  slave  of  inherited  tenden- 
cies and  of  external  surroundings.  Powerless  to  resist, 
unable  to  direct,  why  should  yielding  incur  guilt  or  be 
visited  with  penalties?  Machines  are  not  blamed  or 
punished  ;  and,  under  this  theory  followed  to  an  easily 
reached  extreme,  the  human  being  becomes  a  mere 
piece  of  animated  mechanism.  Moral  distinctions  van- 
ish; right  and  wrong  are  obsolete  and  meaningless 
terms ;  virtue  and  vice  are  fictions  of  the  imagination. 
So-called  bad  men  are  only  weak,  not  wicked ;  unfor- 
tunately organized,  not  morally  culpable;  victims  of 
heredity,  and  not  of  self-created  habits  of  evil-doing. 

This  is  a  phase  of  scientific  fatalism  toward  which  a 
class  of  very  honest  and  zealous  reformers  will  find 
themselves  drifting,  unless  we  are  allowed  to  suppose 
that  some  conservative  and  preservative  forces  exist  in 


WITH   THE    INSANE.  121 

men  and  in  society  which  are  strong  enough  to  resist, 
at  some  point,  inherited  tendencies  to  physical  and 
moral  degradation.  I  am  confident  that  such  forces  do 
exist  I  believe  that  heredity  itself,  when  rightly 
understood  and  correctly  interpreted,  is  a  conserva- 
tive and  not  a  destructive  force.  The  normal  condi- 
tion of  any  organism  is  a  state  of  health,  and  not  of 
disease.  The  native,  natural  tendency  is  to  perpetuate 
the  normal  condition,  unless  the  whole  organism  is 
totally  corrupted,  vitiated  beyond  all  possibility  of 
restoration.  In  this  case,  by  a  merciful  provision  of 
nature,  death  soon  intervenes,  and  the  ruined  individ- 
ual or  family  or  race  disappears. 

Except  in  such  extreme  cases,  inherited  physical  ten- 
dencies can  to-  a  considerable  extent,  at  least,  be  suc- 
cessfully resisted  and  overcome  by  persistent  and  intel- 
ligent efforts.  The  same  is  true  of  transmitted  intel- 
lectual and  moral  traits.  It  is  not  affirmed  that  the 
task  will  be  an  easy  one,  or  that  the  struggle  will  be 
of  short  duration;  but  it  is  most  emphatically  affirmed 
that  every  sane  man's  consciousness  revolts  against  the 
imputation  that  he  is  a  mere  automaton,  destitute  of 
all  self-directing  power.  We  seem  to  ourselves,  at  any 
rate,  to  have  a  form  of  mental  activity  called  choice, 
and  to  be  able  to  give  "preponderance  to  motives." 
We  are  able,  consciously  and  voluntarily,  to  check 
some  impulses  and  to  yield  to  others,  to  give  to  one 
motive  more  weight  than  to  another.  We  feel,  when 
in  a  state  of  ordinary  mental  and  moral  soundness, 


122  TWENTY-FIVE  YEARS 

that  we  are  not  irresistibly  impelled  to  pursue  a  certain 
course  or  to  do  certain  things.  It  is  easy  for  a  theorist 
to  assert  that  we  are  cheated  by  what  we  call  con- 
sciousness ;  but  it  is  not  easy  to  discover  by  what 
means,  or  by  what  course  of  argument,  such  an  asser- 
tion can  be  satisfactorily  established.  There  is  noth- 
ing behind  or  below  consciousness  in  the  soul  to 
which  an  appeal  can  be  made.  Its  decisions  are  of 
necessity  final  in  all  matters  of  this  kind. 

Of  the  influence  of  this  specious  form  of  fatalism, 
Dr.  Carpenter  says : 

"I  can  imagine  nothing  more  paralyzing  to  every  virtuous 
effort,  more  withering  to  every  noble  aspiration,  than  that  our 
children  should  be  brought  up  in  the  belief  that  their  characters 
are  entirely  formed  by  heredity  and  environment;  that  they  must 
do  whatever  their  respective  characters  impel  them  to  do;  that 
they  have  no  other  power  of  resisting  temptations  to  evil  than 
such  as  may  spontaneously  arise  from  the  knowledge  they  have 
acquired  of  what  they  ought  or  ought  not  to  do;  that  if  this 
motive  proves  too  weak  they  can  do  nothing  of  themselves  to 
intensify  and  strengthen  it;  that  the  notion  of  'summoning  their 
resolution,'  or  'bracing  themselves  for  the  conflict,'  is  altogether 
a  delusion;  that,  in  fine,  they  are  in  the  position  of  a  man  who  is 
floating  down  stream  without  oars,  towards  a  dangerous  cataract, 
and  can  only  be  rescued  by  some  external  power." 

How  this  doctrine  weighs  "like  an  incubus"  on  the 
soul  is  well  stated  by  J.  S.  Mill  in  his  autobiography. 
He  says,  "  I  felt  as  if  I  was  scientifically  proved  to  be 
a  helpless  slave  of  antecedent  circumstances ;  as  if  my 
character  and  that  of  all  others  had  been  formed  for  us 
by  agencies  beyond  our  control,  and  was  wholly  out  of 
our  own  power." 


WITH    THE    INSANE.  123 

This  is  essentially  the  condition  in  which  some  of 
the  persons  of  whom  I  have  spoken  believe  themselves 
to  be.  They  are  scientifically  proved  to  be  helpless, 
"fore-ordained"  to  a  fate  which  horrifies  them,  but 
against  which  it  is  worse  than  useless  to  struggle.  It 
is  hardly  necessary  to  say  that  I  am  not  a  believer  in 
this  crushing  species  of  "  fore-ordination."  This  is  not 
the  teaching  of  the  doctrine  of  heredity,  interpreted  by 
reason  or  consciousness. 

Even  J.  S.  Mill,  on  reflection,  reached  another 
conclusion.  "  I  saw,"  he  says,  "  that  though  our  char- 
acters are  formed  by  circumstances,  our  own  desires  can 
do  much  to  shape  those  circumstances  ;  and  that  what  is 
really  inspiriting  and  ennobling  in  the  doctrine  of 
Free-will,  is  the  conviction  that  we  have  real  power 
over  the  formation  of  our  own  characters;  that  our 
will,  by  influencing  some  of  our  circumstances,  can 
modify  our  future  habits  and  capacities  of  willing." 

Mr.  Mill  here  touches  the  heart  of  the  whole  matter. 
In  spite  of  all  theorizing,  we  feel  that  the  will,  unless 
utterly  destroyed  by  the  most  vicious  and  degrading 
habits,  has  some  self-directing  power ;  that  we  can 
modify  and,  to  some  extent,  control  circumstances ; 
that  we  are  not  doomed  to  drunkenness  because  an 
ancestor  has  unfortunately  been  an  inebriate,  or  to 
insanity  because  a  father  or  mother,  or  some  remote 
relative,  has  suffered  from  mental  disease.  It  is  freely 
conceded  that  hidden  tendencies  course  in  our  veins ; 
that  a  taint  vitiates  our  blood ;  that  concealed  enemies 


124  TWENTY-FIVE   YEARS 

lurk  to  pounce  upon  us  at  some  unguarded  moment  ; 
that  constant  watchfulness  is  the  only  guaranty  of 
safety;  —  but  we  are  not  utterly  helpless,  mere  floating 
wrecks,  with  no  power  of  self-direction  and  no  possi- 
bility of  escape  from  the  dangers  which  threaten  us. 

I  recall  in  my  native  neighborhood,  in  a  country 
town  of  New  England,  two  families,  in  one  of  which 
the  father  was  frequently  and  habitually  intoxicated, 
and  in  the  other  the  father  was  habitually  a  constant 
and  hard  drinker.  In  both  families  the  mother  was 
of  most  excellent  character  and  habits.  Each  family 
had  a  half-dozen  children,  a  majority  of  them  boys, 
nearly  all  of  whom  grew  up  to  manhood,  and  several 
of  whom  are  still  living  quite  advanced  in  years. 
Not  one  child  in  either  family  has  been  addicted  to 
the  use  of  intoxicating  drinks,  nor  has  any  one,  so 
far  as  I  have  been  able  to  learn,  suffered  from  any 
form  of  mental  disease.  It  is  true  that  some  of  the 
children  were  born  before  the  fathers  had  fallen  into 
the  confirmed  habit  of  inebriety;  but  not  all  of  them. 
The  latest-born  inherited  less  vigorous  physical  con- 
stitutions, but  otherwise  there  was  no  difference  in 
character.  Examples  can  be  recalled  in  abundance, 
where  children  have  followed  in  the  unhappy  foot- 
steps of  their  besotted  parents.  I  have  adduced  this 
one  to  show  that  such  following  is  not  a  "fore-or- 
dained "  necessity ;  that  there  is  an  innate  power  by 
which  one  can,  if  he  will,  overcome  inherited  inclina- 
tions and  dispositions. 


WITH    THE    INSANE.  125 

This  view  is  confirmed  by  the  testimony  of  a  mul- 
titude of  competent  witnesses  among  specialists  and 
physicians  generally. 

Dr.  Parish  says : 

"The  law  of  heredity  recdgnizes  periods  of  limitation,  as  a 
necessity  for  the  continuance  of  the  race.  If  it  were  not  for  such 
a  law,  and  the  degenerative  process  were  to  be  continued,  with- 
out deviation  or  exhaustion,  the  reproductive  powers  would 
sooner  or  later  terminate,  and  the  race  become  extinct. 

"It  is  evident  that  the  individual  who  is  conscious  of  an 
inherited  tendency  to  alcoholic  excess,  may  do  much  to  modify, 
if  not  to  control  its  force,  by  placing  himself  under  such  condi- 
tions of  living  as  will  tend  to  increase  his  constitutional  vigor  in 
the  direction  in  which  it  is  most  needed.  A  person  coming  into 
the  world  with  a  tendency  to  pulmonary  consumption  will,  as 
soon  as  he  knows  it,  begin  to  correlate  himself  with  the  most  fav- 
orable conditions  of  climate,  occupation,  etc.,  that  the  progress 
of  the  morbific  element  within  him  may  be  arrested,  if  possible, 
and  that  the  normal  forces  that  are  antagonistic  to  this  manifest- 
ation of  disease  may  be  strengthened.  The  same  is  true  of  other 
disorders. 

"A  person  with  a  direct  hereditary  taint  for  insanity  may  pur- 
sue a  course  of  life,  under  professional  guidance,  which  will 
secure  him  against  a  public  exhibition  of  his  infirmity,  with  more 
certainty  than  a  person  with  an  alcoholic  diathesis  can  be  kept  from 
indulgence  and  exposure.  In  the  former  there  is  no  physical 
craving  to  overcome,  no  struggle  with  an  internal  and  positive 
demand,  which,  strong  and  imperious  itself,  is  rendered  more  so 
by  the  allurements  of  social  and  the  attractive  displays  of  public 
life.  All  that  is  required  in  case  of  the  insane  tendency  is,  in  the 
very  outset,  to  submit  to  intelligent  guidance  as  to  mental  and 
physical  hygiene,  so  as  to  preserve  a  normal  equipoise." 

•  Dr.  Hitchcock,  writing  upon  the  fearful  "Entail- 
ments  of  Alcohol,"  says: 


126  TWENTY-FIVE    YEARS 

"Can  a  young  man  who,  from  some  taint  of  blood,  has  inher- 
ited from  his  parents  or  ancestors  that  morbid  desire  for 
stimulants,  be  secured  from  this  brood  of  evils?  Yes,  if  the 
taint  of  blood  is  not  so  strong  as  to  wholly  enervate  the  will; 
but  he  only  by  total  abstaining.  And  is  it  not  possible  that  by 
so  doing,  and  by  intermarrying  with  a  person  in  whose  blood 
there  is  no  such  taint,  he  may  do  much  towards  eliminating  that 
taint  from  his  descendants?" 

That  which  must  be  done  in  respect  to  the  "  taint " 
of  alcohol,  can  more  surely  be  done  in  respect  to  the 
less  terrible  taint  of  insanity. 

Dr.  Van  Deusen  writes: 

"To  have  an  inherited  capacity  for  mental  disease  is  one 
thing,  and  to  have  a  parent  or  relative  who  may  have  been  insane 
may  be  quite  another.  The  somewhat  general  impression  that 
the  child  of  a  parent  who  has  been  insane,  is  quite  sure  to  suffer 
in  the  same  manner,  is  by  no  means  correct;  it  is  often  mischiev- 
ous, in  suspending  over  the  child  a  painful  and  ever-present 
apprehension,  generally  morbid  in  its  influence,  and  of  service, 
perhaps,  when  it  leads  to  a  judicious  and  healthful  system  of 
development  and  discipline,  and  more  carefully  regulated 
habits  of  life.  It  is  evident  enough  that  there  can  be  no  possible 
direct  transmission  to  offspring  in  the  case  of  a  parent  who, 
many  years  after  the  birth  of  a  child,  from  purely  physical 
causes,  may  suffer  from  an  attack  of  mental  disease. 

"In  this  connection  it  may  be  of  some  advantage  to  suggest  to 
the  friends  of  insane  parents  the  importance  of  preventing 
intimate  and  protracted  association  with  their  children  in  the 
early  years  of  their  development.  The  sadly  depressing  effect 
of  such  association  has  very  frequently  been  demonstrated, 
especially  in  case  of  an  insane  mother  and  her  daughter.  The 
fact  of  the  existence  of  such  an  influence  is  too  important  to  be 
disregarded." 

"Our  experience  leads  to  the  conclusion  that,  (1),  about  one- 
third  of  all  presented  for  treatment  have  immediate  relatives  who 


WITH  THE   INSANE.  127 

have  been  insane;  (2),  that  most  forms  of  mental  disease  are 
equally  curable,  whether  the  patient  has  sane  or  insane  relatives ; 
(3),  that  individuals  of  ordinarily  good  mental  and  physical  con- 
stitution, in  whom  recovery  is  perfect,  are  less  likely  to  have  a 
second  attack;  while,  (4),  those  who  inherit  an  unhealthy  organ- 
ization will  probably  suffer  from  subsequent  attacks. " 

Dr.  Hard  says : 

"In  many  instances  persons  possessing  susceptible  nervous 
organizations  suffer  much  unnecessary  apprehension  because  an 
immediate  relative  has  been  insane,  when  the  fact  may  not  have 
any  bearing  upon  their  own  prospect  of  developing  insanity. 
The  insanity  of  old  age  or  of  the  climacteric  period  can  not  be 
regarded  as  transmissible. 

"What  does  an  insane  parent  transmit  to  his  offspring?  In  a 
vast  majority  of  cases  there  is  transmitted  only  a  predisposition  to 
mental  disease;  mental  disease  itself  is  not  transmitted,  but  an 
impressible  mental  organization  which,  under  favoring  circum- 
stances, is  prone  to  take  on  diseased  action.  The  inheritance  of  a 
predisposition  to  mental  disease  does  not  affect  unfavorably  the 
prospect  of  recovery  in  case  of  attack. 

' '  Insanity  is  not  invariably  developed  where  a  predisposition 
exists.  The  person  who  inherits  such  predisposition  should 
form  careful  habits  of  living.  Excesses  should  be  avoided; 
everything  which  produces  mental  strain  or  worry  should  be 
scrupulously  shunned,  and  the  individual  should,  as  far  as  pos- 
sible, be  contented  to  lead  a  quiet  life,  subjected  to  the  fewest 
possible  disturbing  influences." 

Such  testimony  ought  to  relieve,  in  good  measure, 
those  who  may  have  been  unduly  anxious  on  account 
of  some  real  or  supposed  inherited  tendency.  At  the 
same  time,  the  imperative  necessity  of  taking  all  pos- 
sible precaution  against  uncalled-for  exposure  to  phy- 
sical exhaustion,  or  nervous  and-  mental  excitement, 
should  be  impressed  upon  them  and  upon  their  friends. 


128  TWENTY-FIVE   YEARS 


CHAPTER  XVI. 
INSANITY  AND   CRIME. 

It  will  appear  to  border  closely  on  presumption  for 
one  who  is  neither  a  lawyer,  physician,  or  a  specialist, 
to  express  with  much  freedom  opinions  touching  the 
responsibility  of  the  insane  and  the  treatment  by  the 
courts  of  person's  charged  with  crime  and  defended 
on -the  plea  of  mental  disease. 

It  is  freely  conceded  that  only  those  who  have 
made  insanity  a  subject  of  profound  study,  and  have 
had  opportunities  to  observe,  for  protracted  periods 
and  under  favorable  conditions,  the  conduct  of  the 
insane  and  the  peculiar  and  varied  manifestations  of 
disordered  mental  and  moral  activity,  are  fully  con> 
petent  to  prescribe  and  apply  tests  of  responsibility 
in  cases  where  misconduct  or  criminal  acts  are  laid  to 
the  charge  of  persons  suspected  of  mental  unsound- 
ness.  The  question  of  responsibility  in  such  cases  is 
confessedly  surrounded  with  very  great  and  grave 
difficulties,  and  justice  and  humanity  unite  in  de- 
manding of  those  who  are  to  give  answer  to  it  the 
utmost  candor,  the  most  unwearied  patience,  and  a 
willingness  to  be  instructed  even  at  the  risk  of 
acknowledging  previous  ignorance. 

The  problem  is  rendered  more  perplexing  to  the 
ordinary  observer,  and  its  solution  is  made  more 


WITH   THE    INSANE.  129 

hopeless,  by  the  fact  that  in  cases  which  come  before 
the  courts  specialists,  apparently  equally  well-in- 
formed and  equally  well-intentioned,  give  opinions 
and  reach  conclusions  of  a  widely  different  character. 
One  is  very  forcibly  reminded  of  the  antiquated 
adage,  ""When  doctors  disagree."  The  confusion  is 
still  further  confounded  by  contentions,  charges,  and 
counter-charges,  between  the  medical  and  legal  pro- 
fessions. The  doctors  propose  one  standard  of 
responsibility  and  the  lawyers  insist  upon  another. 
In  the  din  which  often  arises  the  common  people  not 
unnaturally  conclude  that  nothing  is  positively 
known  about  the  matter,  and  fall  back  contentedly 
and  complacently  upon  the  traditional  notions  which 
they  have  inherited  from  the  ignorance  and  prejudice 
of  the  past.  Juries  composed  of  such  people,  and 
perhaps  unconsciously  influenced  by  the  passions  and 
sentiments  of  the  hour,  alternate  in  their  verdicts 
from  severity  which  borders  on  barbarism  to  leniency 
which  more  than  borders  on  impunity  to  disorder  and 
crime.  In  one  case  a  man  obviously  insane  is  con- 
demned to  death,  while  in  another  case  a  criminal 
worthy  of  the  severest  punishment  is  set  free  on  the 
convenient  but  shallow  plea  of  "emotional  insanity." 
The  height  of  absurdity  was  reached,  and  the  mock- 
ery of  legal  forms  was  completed,  when  a  jury 
declared,  in  substance,  "  We  find  that  the  accused 
was  entirely  sane  the  moment  before  and  the  moment 
after  the  act  [deliberate  killing]  was  committed,  but 

9 


130  TWENTY-FIVE   YEARS 

we  have  doubt  of  his  sanity  at  the  instant  when  the 
deed  was  done."  The  prisoner  was  allowed  the  bene- 
fit of  the  doubt,  and  turned  loose  into  the  community 
to  repeat  the  act,  if  a  similar  impulse  should  seize 
upon  him  under  some  real  or  supposed  provocation. 

Under  all  the  circumstances  it  seems  to  me  to  be 
within  the  limits  of  forgiveness  if  an  untrained  lay- 
man, a  mere  common  observer,  should  venture  the 
expression  of  an  opinion  or  the  utterance  of  some 
inquiries.  I  can  not  resist  the  impression  that  in  the 
treatment  of  insanity  and  the  insane,  the  legal  profes- 
sion and  the  courts  of  law  have  not  kept  abreast  of 
the  general  progress  of  the  age.  The  impression  may 
be  a  false  one,  but  it  is,  nevertheless,  deeply  fixed. 
The  scenes  connected  with  the  trial  of  the  assassin  of 
President  Garfield,  and  scenes  connected  with  the 
trials  of  less  famous  criminals,  have  served  to  inten- 
sify this  into  a  nearly  settled  opinion.  The  opinion 
or  belief  of  an  obscure  individual  is  of  little  impor- 
tance, but  if  it  should  be  true  that  the  same  impres- 
sion is  fastening  itself  upon  the  minds  of  the  great 
body  of  fairly  intelligent  citizens,  the  opinion,  or 
belief,  becomes  of  consequence  to  the  law-making  and 
law-administering  powers.  Trials  can  not  degenerate 
into  broad  farces  and  courts  into  objects  of  ridicule 
and  contempt  without  serious  danger  to  the  highest 
interests  of  the  whole  body  of  the  people,  to  say 
nothing  of  the  safety  of  the  unfortunate  or  the  crimi- 
nal. It  may  be  of  service  here,  to  the  unprofessional 


WITH  THE   INSANE.  131 

reader,  to  borrow  some  statements  of  the  principles 
and  rules  by  which  the  courts  have  been,  and  still  are, 
governed  in  the  administration  of  justice  in  cases 
involving,  or  supposed  to  involve,  the  question  of 
insanity. 

In  the  seventeenth  century,  Lord  Hale,  one  of  the 
most  learned  and  upright  judges  of  England,  said : 

' '  There  is  a  partial  insanity  and  a  total  insanity.  Some  per- 
sons that  have  a  competent  use  of  reason  in  respect  of  some 
subjects,  are  yet  under  a  particular  dementia  in  respect  of 
some  particular  discourses,  subjects,  or  applications;  —  or  else  it 
is  partial  in  respect  of  degrees;  and  this  is  the  condition  of  very 
many,  especially  melancholy  persons,  who  for  the  most  part  dis- 
cover their  defects  in  excessive  fears  and  griefs,  and  yet  are  not 
wholly  destitute  of  the  use  of  reason;  and  this  partial  insanity 
seems  not  to  excuse  them  in  the  committing  of  any  offence  for  its 
matter  capital ;  for,  doubtless,  most  persons  that  are  felons  of 
themselves  and  others  are  under  a  degree  of  partial  insanity 
when  they  commit  these  offences.  It  is  very  difficult  to  define 
the  invisible  line  that  divides  perfect  and  partial  insanity;  but  it 
must  rest  upon  circumstances  duly  to  be  weighed  by  judge  and 
jury,  lest,  on  the  one  side,  there  be  a  kind  of  inhumanity  towards 
the  defects  of  human  nature ,  or,  on  the  other  side,  too  great  an 
indulgence  given  to  great  crimes." 

It  is  assumed  in  this  declaration  that  an  insane 
man  may  properly  and  justly  be  punished  for  any 
acts  committed,  provided  his  insanity  is  partial  and 
not  total.  Under  this  principle  a  large  majority, 
indeed  nearly  all,  of  those  charged  with  crimes  and 
defended  on  the  plea  of  mental  disease,  would  be 
classed  among  the  partially  insane.  At  a  later  pe- 


132  TWENTY-FIVE   YEARS 

riod,  in  1723,  the  doctrine  of  Lord  Hale  was  expressed 
in  plainer  language  by  Justice  Tracy.     He  said  : 

"  It  is  not  every  kind  of  frantic  humour,  or  something  unac- 
countable in  a  man's  actions,  that  points  him  out  to  be  such  a 
madman  as  is  exempted  from  punishment.  It  must  be  a  man 
that  is  totally  deprived  of  his  understanding  and  memory,  and 
doth  not  know  what  he  is  doing,  no  more  than  an  infant,  than  a 
brute  or  a  wild  beast;  such  a  one  is  never  the  object  of  punish- 
ment. " 

This  was  very  naturally  known  as  "the  wild 
beast  theory." 

The  unprofessional  mind  is  perplexed  to  discover 
that  the  same  rule  in  relation  to  insanity  did  not 
apply  to  both  criminal  and  civil  cases.  A  person 
might  be  adjudged  unfit  to  take  proper  care  of  him- 
self, or  to  manage  his  business  affairs,  to  make 
bargains  or  to  dispose  of  property,  and  yet  be  hanged 
for  murder  or  imprisoned  for  theft.  This  is  ex- 
pressly stated  by  Chief  Justice  Mansfield  in  a 
remarkable  trial  which  occurred  in  1812.  He  says, 
"  Upon  the  authority  of  the  first  sages  in  the  country, 
and  upon  the  authority  of  the  established  law  in  all 
times,  which  has  never  been  questioned,  that  although 
a  man  might  be  incapable  of  conducting  his  own 
affairs,  he  may  still  be  answerable  for  his  criminal 
acts,  if  he  possess  a  mind  capable  of  distinguishing 
right  from  wrong."  There  is  in  this  declaration  a 
slight  advance  from  the  doctrine  of  Lord  Hale.  Such 
knowledge  as  the  infant  or  the  brute  may  be  supposed 


WITH  THE   INSANE.  133 

to  have,  is  exchanged  for  the  somewhat  higher  knowl- 
edge of  "right  and  wrong." 

Yet  most  unfortunately  this  knowledge  is  of  a  gen- 
eral and  not  of  a  specific  character.  That  is,  the 
person  is  held  responsible  if  he  can  distinguish  right 
from  wrong  in  ordinary  affairs,  no  matter  how  con- 
fused or  warped  his  judgment  may  be  in  respect  to 
the  crime  with  which  he  is  charged.  Lord  Mansfield 
himself,  in  speaking  of  a  case  in  which  a  patient, 
laboring  under  the  delusion  of  having  been  injured, 
takes  revenge  by  violence,  says,  "If  such  a  person 
were  capable,  in  other  respects,  of  distinguishing  right 
from  wrong,  there  was  no  excuse  for  any  act  of 
atrocity  which  he  might  commit  under  this  descrip- 
tion of  derangement.  It  must  be  proved  beyond  all 
doubt  that  at  the  time  he  committed  the  atrocious 
act,  he  did  not  consider  that  murder  was  a  crime 
against  the  laws  of  Grod  and  nature."  Very  few,  if 
any,  insane  homicides  could  escape  conviction  for 
murder  in  a  court  governed  by  this  rule.  The  over- 
mastering power  of  a  delusive  idea,  driving  one  on 
over  the  opposing  forces  of  knowledge,  judgment, 
conscience,  and  natural  affection,  is  not  recognized. 
The  point  upon  which  the  whole  question  of  respon- 
sibility depends  has  thus  far  eluded  the  legal  mind. 
In  commenting  upon  the  doctrine  of  Lord  Mansfield, 
Dr.  Kay  says : 

"That  the  insane  mind  is  not  entirely  deprived  of  this  power 
of  moral  discernment,  but  on  many  subjects  is  perfectly  rational 


134  TWENTY-FIVE   YEARS 

and  displays  the  exercise  of  a  sound  and  well-balanced  mind,  is 
one  of  those  facts  now  so  well  established,  that  to  question  it 
would  only  display  the  height  of  ignorance  and  presumption. 
The  first  result,  therefore,  to  which  the  doctrine  leads  is,  that  no- 
man  can  successfully  plead  insanity  in  defence  of  crime;  because 
it  can  be  said  of  no  one  who  would  have  occasion  for  such  a 
defence,  that  he  was  unable  in  any  case  to  distinguish  right  from 
wrong.  .  .  The  purest  minds  can  not  express  greater  horror 
and  loathing  of  various  crimes  than  madmen  often  do,  and  from 
precisely  the  same  causes.  Their  abstract  conceptions  of  crime, 
not  being  perverted  by  the  influence  of  disease,  present  its  hide- 
ous outlines  as  they  ever  were  in  the  healthiest  condition;  and 
the  disapprobation  they  express  at  the  sight  arises  from  sincere 
and  honest  convictions.  The  particular  criminal  act,  however, 
becomes  divorced  in  their  minds  from  its  relations  to  crime  in 
the  abstract;  and  being  regarded  only  in  connection  with  some 
favorite  object  which  it  may  help  to  obtain,  and  which  they  see 
no  reason  to  refrain  from  pursuing,  is  viewed,  in  fact,  as  of  a 
highly  laudable  and  meritorious  nature.  Herein,  then,  consists 
their  insanity,  not  in  preferring  vice  to  virtue,  in  applauding 
crime  and  deriding  justice,  but  in  being  unable  to  discern  the 
essential  identity  of  nature  between  a  particular  crime  and  all 
other  crimes,  whereby  they  are  led  to  approve  what,  in  general 
terms,  they  have  already  condemned.  It  is  a  fact,  not  calculated 
to  increase  our  faith  in  the  'march  of  intellect,'  that  the  very 
trait  peculiarly  characteristic  of  insanity  has  been  seized  upon  as 
a  conclusive  proof  of  sanity  in  doubtful  cases;  and  thus  the 
infirmity  that  entitles  one  to  protection,  is  tortured  into  a  good 
and  sufficient  reason  for  completing  his  ruin." 

At  a  later  period  the  English  judges  declared  that 
"  to  establish  a  defence  on  the  ground  of  insanity,  it 
must  be  clearly  proved  that,  at  the  time  of  commit- 
ting the  act,  the  party  accused  was  laboring  under 
such  a  defect  of  reason  from  disease  of  the  mind  as 


WITH   THE   INSANE.  135 

Dot  to  know  the  nature  and  quality  of  the  act  he  was 
doing,  or,  if  he  did  know  it,  that  he  did  not  know  he 
was  doing  what  was  wrong." 

This  is  a  long  stride  in  advance  of  the  rule  that  an 
accused  person  is  to  be  held  responsible  for  his  acts, 
however  insane  he  may  obviously  be,  provided  he 
has  a  general  knowledge  of  right  and  wrong.  Unfort- 
unately the  doctrine  enunciated  in  the  statement 
quoted  was  seriously  modified  by  subsequent  rules, 
and  was  made  less  favorable  to  the  ends  of  justice. 
An  English  writer  of  high  standing  says  of  trials  in 
the  English  courts : 

"  It  is  notorious  that  the  acquittal  or  conviction  of  a  prisoner, 
when  insanity  is  alleged,  is  a  matter  of  chance.  Were  the  issue 
to  be  decided  by  tossing  up  a  shilling,  instead  of  by  the  grave  pro- 
cedure of  a  trial  by  court,  it  could  hardly  be  more  uncertain. 
The  less  insane  person  sometimes  escapes,  while  the  more  insane 
person  is  sometimes  hanged;  one  man  laboring  under  a  particu- 
lar derangement  is  acquitted  at  one  trial,  while  another  having 
an  exactly  similar  form  of  derangement  is  convicted  at  another 
trial.  No  one  will  be  found  to  uphold  this  state  of  things  as 
satisfactory,  although  there  is  great  difference  of  opinion  as  to 
the  cause  of  the  uncertainty;  the  lawyers  asserting  that  it  is 
owing  to  the  fanciful  theories  of  medical  men  who  never  fail  to 
find  insanity  where  they  earnestly  look  for  it,  the  latter  protest- 
ing that  it  is  owing  to  the  absurd  and  unjust  criterion  of  re- 
sponsibility which  is  sanctioned  by  the  law." 

The  same  language  might  be  used  in  describing 
the  state  of  affairs  in  the  United  States  and  probably 
in  all  civilized  countries.  Surely  it  may  be  pardon- 
able to  suggest  that  such  a  condition  of  things  is 


136  TWENTY-FIVE    YEARS 

humiliating  in  the  extreme,  if  not  positively  dis- 
graceful to  the  intelligence  of  two  of  the  learned 
professions.  Happily  the  administration  of  law  is 
often  better  than  the  law  itself,  and  innocence, 
exposed  to  injustice  by  the  letter  of  the  statute  or 
the  rule,  is  protected  by  the  intervention  of  a  court 
where  the  presiding  justice  has  the  humanity  and 
courage  to  set  aside  the  authority  of  technical  defini- 
tions and  antiquated  rulings,  and  to  decide  in  accord- 
ance with  the  teachings  of  modern  science  and  with 
the  spirit  of  an  age  more  humane  than  that  of  Lord 
Hale  or  Lord  Mansfield.  But  the  sense  of  right  and 
justice  in  individual  judges  is  usually  powerless, 
under  existing  laws  and  rules  of  proceeding,  to  prevent 
injustice  or  to  correct  erroneous  verdicts.  Some  rad- 
ical changes  are  needed.  Only  thoroughly  trained 
specialists  in  the  law  and  in  mental  disease  are  com- 
petent to  suggest  the  details  of  such  changes ;  but  it 
may  be  allowable  for  any  one  whose  attention  has 
been  turned  in  that  direction,  to  make  inquiries  or 
even  to  express  an  opinion.  Such  inquiries  and 
expressions  may  help  towards  the  formation  of  a  pub- 
lic sentiment  which  shall  demand  improvements  in 
the  laws  and  in  the  methods  of  their  adminis- 
tration. 

In  cases  of  crime  in  which  insanity  is  claimed  as  a 
ground  of  defence,  ought  not  the  question  of  sanity 
or  insanity  to  be  examined  and  determined  entirely 
apart  from  the  question  of  the  criminal  act  itself? 


WITH    THE    INSANE.  137 

Let  the  trial  of  one  question,  the  question  of  insanity, 
either  precede  or  follow  the  trial  as  to  the  act  or 
crime  charged.  Let  the  tribunal  be  one  having  some 
fitness  for  the  examination  and  decision  of  such  a 
question,  and  not  an  ordinary  jury.  It  is  no  imputa- 
tion upon  the  intelligence  or  honesty  of  the  members 
of  an  ordinary  jury  to  say  that  they  have  no  compe- 
tency for  the  determination  of  such  a  question.  In- 
sanity is  either  itself  a  disease,  or  it  is  the  result  of  a 
disease,  as  much  as  diphtheria  or  typhoid  fever.  A 
jury  of  farmers,  mechanics,  or  merchants,  would 
hardly  be  expected  to  decide  satisfactorily  whether 
an  alleged  case  of  typhoid  fever  were  that  disease 
or  some  other.  It  is  hardly  less  absurd  to  set  the 
same  men  to  determine  whether  an  act  of  brutal 
assault  is  the  offspring  of  a  violent  insane  delusion, 
or  of  an  ungovernable  feeling  of  ill-will  and  revenge. 
Should  not  a  court,  when  it  is  claimed  that  a  pris- 
oner is  insane,  or  was  insane  at  the  time  the  offence 
was  committed,  be  authorized,  and  under  some  cir- 
cumstances be  required,  to  summon  a  small  jury 
of  men  familiar  with  all  forms  and  peculiarities  of 
mental  disorders,  and  to  submit  to  them  the  simple 
question  of  responsibility  ?  Is  the  prisoner  of 
unsound  mind?  and,  if  so,  is  the  unsoundness  of 
such  a  character  as  to  render  him  legally  irresponsi- 
ble for  the  supposed  crime?  In  many  cases  this 
question  could  be  determined  before  any  other  pro- 
ceedings were  had,  and  if  the  irresponsibility  were 


138  TWENTY-FIVE   YEARS 

clearly  established,  no  further  trial  would  be  neces- 
sary. In  this  way,  in  many  cases,  much  time,  great 
expense,  and  often  unwholesome  excitement  would  be 
saved,  and  the  ends  of  justice  would  be  easily  and 
promptly  attained. 

In  cases  where  insanity  is  obscure  or  doubtful, 
this  jury  of  experts  might  be  summoned  to  attend, 
observe  the  prisoner,  the  witnesses,  and  the  whole 
proceedings  during  the  trial  as  to  the  fact  before  the 
usual  jury,  and,  in  case  of  conviction,  might  after- 
wards render  their  verdict  in  respect  to  sanity  and 
responsibility.  The  ordinary  jury  takes  no  cogni- 
zance of  the  question  of  insanity.  It  considers  the 
question  of  guilt  or  innocence  as  in  any  other  case, 
and  that  alone. 

It  is  not  to  be  anticipated  that  this  or  any  simi- 
lar method  of  dealing  with  criminals  suspected  of 
insanity  will  be  immediately  adopted.  Meanwhile 
may  we  not  hope  for  a  less  radical,  but  still  an 
important  improvement  in  legal  practice  ?  As  mat- 
ters now  are,  in  trials  involving  the  plea  of  insanity, 
expert  witnesses  are  employed  by  both  sides,  and 
these  witnesses  are  examined  and  cross-examined 
very  much  as  other  witnesses  are.  The  position  is  a 
humiliating  one  to  intelligent,  honorable,  and  high- 
minded  gentlemen.  The  result  does  not  always  tend 
to  further  the  ends  of  justice.  The  spectacle  some- 
times becomes  little  less  than  disgraceful  if  the  advo- 
cates happen  to  be  of  that  peculiar  character  fre- 


WITH   THE   INSANE. 

quently  found  in  what  are  known  as  "  criminal 
lawyers."  It  will  be  permitted,  even  for  a  very 
common  observer,  to  affirm  that  this  mode  of  con- 
ducting such  trials  ought  to  be  changed  at  once. 

When  such  witnesses  are  asked  to  give  opinions, 
they  should  be  invited  by  the  court  itself.  Questions 
should  be  propounded  by  the  court.  Interrogations 
should  relate,  not  merely  to  supposed  and  hypothet- 
ical cases  and  conditions,  but  to  the  case  in  hand  and 
to  the  prisoner  at  the  bar.  Paid  advocates  should 
stand  aside,  whether  of  the  prosecution  or  the  de- 
fence. The  object  is  not  to  convict  or  acquit,  but  to 
secure,  if  possible,  exact  justice  to  all  parties. 

It  is  difficult  to  see  why  so  much  of  reform  and 
improvement  might  not  easily  be  made.  It  is  evi- 
dent that  the  interests  of  the  community  would 
thereby  be  better  guarded,  and  the  insane  themselves- 
be  put  in  a  position  of  greater  safety. 

It  is  not  likely  that  any  single  principle  can  ever 
be  laid  down  by  the  courts,  or  any  statement  can  be 
made  by  specialists  in  the  study  of  mental  disease,, 
which  shall  serve  as  a  practical  test  of  sanity  or 
insanity  when  applied  by  .ordinary  juries,  or  by 
unprofessional  men  in  the  common  relations  of  life. 
While  it  is  possible  that  some  characteristics  may 
pertain  to  all  patients  suffering  from  insanity,  it  i& 
yet  probably  true  that  each  case  exhibits  many 
peculiarities  of  its  own,  and  must  be  considered  by 
itself.  The  responsibility  or  irresponsibility  of  each. 


140  TWENTY-FIVE  YEAES 

accused  man  or  woman,  in  whose  case  insanity  is 
alleged  or  suspected,  must  be  determined,  not  by 
specific  rules,  but  by  competent  men  after  the  fullest 
possible  investigation  of  all  the  conditions,  and  cir- 
cumstances, and  indications  of  that  individual  case. 
No  more  perplexing  problem  confronts  students  of 
moral  philosophy  and  political  economy  and  social 
science,  than  the  question  of  the  responsibility  and 
proper  treatment  of,  not  only  the  recognized  insane 
when  charged  with  crime,  but  of  that  large  and  grow- 
ing class  which  inhabits  a  sort  of  borderland,  where 
insanity,  and  crime,  and  defective  physical  and  men- 
tal organization,  and  inherited  evil  tendencies,  and 
vile  surroundings,  and  filthy  habits  all  meet  and 
mingle  in  one  common  cesspool  of  indescribable  pol- 
lution and  degradation.  Civilization  and  society 
must  be  defended  against  the  unthrift  and  marauding 
depredations  of  this  unfortunate  class.  Restraints 
must  be  imposed,  and  penalties  must  be  inflicted ;  but 
mercy  and  compassion  surely  have  some  place  in 
dealing  with  this  corrupt  and  corrupting  mass  of 
humanity.  Eestraints  and  penalties,  as  usually  in- 
flicted, have  little  tendency  to  elevate,  purify,  and 
reclaim.  The  field  is  not  an  inviting  one,  but  there 
is  need  that  it  be  fully  explored.  To  what  extent 
does  legal  and  moral  responsibility  attach  to  the 
members  of  this  class  ?  Can  they  be,  in  some  way, 
segregated,  and  educated,  and  trained  up  into  decency 
and  manhood  ?  Must  we  have  a  horde  of  criminals 


WITH  THE   INSANE.  141 

propagating  itself,  warring  against  society,  a  constant 
source  of  danger,  a  standing  and  perpetual  menace 
against  good  order  and  prosperity  ?  These  and  kin- 
dred questions  are  fast  becoming  of  vital  importance 
to  the  statesman,  the  philanthropist,  and  the  Chris- 
tian, and  they  are  crowding  themselves  forward  and 
demanding  some  sort  of  solution. 


CHAPTER  XVII. 
CONCLUDING   THOUGHTS. 

Increase  of  Insanity. — The  figures  of  each  successive 
census  seem  to  show  an  increase  in  the  relative  num- 
ber of  the  insane  in  all  the  States  of  the  Union.  The 
apparent  is  probably  somewhat  greater  than  the  act- 
ual increase,  from  the  fact  that  more  care  has  been 
taken  during  the  last  decades  to  obtain  full  and  trust- 
worthy information  in  relation  to  this  subject.  There 
is,  also,  less  unwillingness  on  the  part  of  relatives  and 
friends  to  admit  the  existence  of  mental  disease  in 
their  families,  and  to  afford  facilities  for  learning  the 
exact  truth  in  respect  to  persons  thus  afflicted.  Not 
very  far  back  in  the  past  the  feeling  prevailed  that, 
in  some  unexplained  way,  something  of  disgrace 
attached  itself  to  this  form  of  suffering.  Under  the 
influence  of  this  feeling  men  and  women  put  their 
friends,  who  had  become  insane,  out  of  their  own 
sight  and  the  sight  of  others,  as  far  as  possible.  They 


142  TWENTY-FIVE    YEARS 

seldom  spoke  of  them.  The  insane  were,  in  many 
•cases,  practically  dead  and  buried.  Unless  by  acci- 
dent their  existence  could  not  be  ascertained  by 
public  officers. 

To  a  considerable  extent  this  unfortunate  impres- 
sion has  been  effaced.  With  other  inherited  relics  of 
old  superstitions  it  has  either  entirely  disappeared, 
or,  at  any  rate,  is  confined  mostly  to  the  dark  nooks 
and  by-ways  of  society.  Insanity  is  regarded  as  a 
result  of  physical  disease ;  and  this  disease  carries 
with  it  no  more  of  reproach  or  disgrace  than  other 
disorders.  It  is  possible,  therefore,  to  obtain  statistics 
relating  to  the  insane,  upon  which  a  fair  degree  of 
reliance  may  be  placed. 

Another  reason  for  this  reported  increase  readily 
suggests  itself  to  one  at  all  acquainted  with  former 
and  present  methods  of  treating  the  insane.  Under 
the  system  of  neglect  and  barbarism  practiced  in  not 
very  remote  times,  all  except  those  of  hardy  and 
vigorous  constitutions  soon  died.  There  was  no 
accumulation  in  private  places  of  detention,  or  in 
public  receptacles,  of  the  weak  and  feeble.  The  con- 
dition of  affairs  is  now  entirely  different.  More 
humane  and  wiser  treatment  lengthens,  by  many 
years,  the  lives  of  large  numbers  of  incurable  patients. 
A  few  of  the  inmates  of  the  Michigan  Asylum  have 
been  there  twenty-five  years,  and  probably  the  older 
institutions  have  patients  who  have  survived  for  a 
still  longer  period.  In  consequence  of  this  preserva- 


WITH  THE   INSANE.  143 

tion  of  chronic  invalids,  the  increase  in  the  relative 
number  of  the  insane,  without  doubt,  appears  to  be 
greater  than  it  really  is. 

But  after  making  all  possible  reduction  from  the 
results  of  census  figures,  for  the  reasons  mentioned 
and  for  others  which  might  be  given,  it  remains  true, 
beyond  reasonable  doubt,  that  mental  disease  has 
increased  during  the  last  half-century,  and  is  still 
increasing.  The  rate  of  increase,  while  not  such  as  to 
give  occasion  for  serious  apprehension,  is  sufficient  to 
challenge  attention  and  to  demand  a  careful  examina- 
tion of  probable  causes.  It  is  not  within  my  purpose 
to  enter  upon  any  extended  discussion  of  these  causes. 
Some  of  them  are  easy  to  discover,  and  have  been 
necessarily  touched  upon  in  previous  chapters.  Others 
are  more  obscure,  and  their  profitable  discussion 
would  call  for  knowledge  which  I  can  not  claim  to 
possess.  Too  many  crude  and  half-digested  theories 
have  already  been  put  forth  by  persons  whose  zeal 
and  good  intentions  have  greatly  outrun  their  wisdom  • 
and  discretion.  One  may  be  pardoned,  however,  for 
hesitating  to  admit  that  insanity  is  a  necessary 
product  of  civilization. 

Prevention  of  Insanity.  —  The  true  province  of  gov- 
ernment is  to  prevent  rather  than  to  punish  crime. 
So,  it  seems  to  me,  the  great  purpose  of  medical 
science  and  of  physicians  should  be  the  prevention 
rather  than  the  cure  of  disease.  This  is  especially 


144  TWENTY-FIVE  YEARS 

true  in  respect  to  insanity.  The  erection  and  sup- 
port of  asylums,  in  addition  to  institutions  of  a  penal 
and  reformatory  character,  are  imposing  heavy  bur- 
dens upon  the  community.  It  is  impossible  to 
provide  accommodations  enough  to  meet  the  growing 
demands.  One  asylum  is  hardly  completed  before 
another  is  called  for.  As  a  matter  of  mere  economy, 
to  say  nothing  of  the  question  of  humanity,  the  State 
could  well  afford  to  provide  for  the  most  extensive 
and  thorough  investigation  into  the  causes  and  con- 
ditions of  mental  disease,  and  the  means  and 
measures  by  which  it  may  be  prevented.  It  would 
be  for  the  economical  interests  of  the  State  to  publislj 
the  results  of  such  investigations,  and  to  employ 
efficient  agencies  to  circulate  this  information  among 
the  people.  It  is  easy  to  discover  difficulties  in  the 
way  of  prosecuting  a  work  of  this  kind,  but  they 
are  not  insurmountable.  It  is  morally  certain  that 
ignorance  is  responsible  for  a  large  percentage 
of  suffering  in  this  as  well  as  in  other  directions. 
While  waiting  for  competent  authorities  to  make 
other  and  more  extended  investigations,  it  will  be 
profitable  for  us  to  sum  up  briefly  some  of  the  con- 
clusions already  reached,  and  to  make  practical  use 
of  the  lessons  which  they  teach. 

Intermarriage  of  near  Relatives,  etc. — A  very  wide 
diversity  of  opinion  is  found,  in  works  of  medical 
and  other  writers,  in  respect  to  consanguineous  mar- 


WITH  THE   INSANE.  145 

riages.  Some  affirm,  with  great  positiveness,  that 
the  effects  of  such  marriages  upon  offspring  are  gen- 
erally, if  not  always,  harmful.  Others  question,  if 
they  do  not  deny,  the  correctness  of  this  conclusion. 
The  predominance  of  testimony,  however,  is  decid- 
edly against  the  advisability  of  intermarriage  by 
persons  nearly  related  by  blood.  If  it  were  certain 
that  the  parties  to  such  a  union  were  both  perfectly 
sound  in  every  respect,  in  body  and  mind,  it  might 
reasonably  be  expected  that  the  offspring  would  have 
no  unfortunate  physical  or  mental  inheritance.  Such 
cases,  if  ever  found,  are  very  infrequent.  The  dan- 
ger is  that  the  husband  and  wife,  coming,  at  so  little 
remove,  from  the  same  stock,  will  have  the  same  or 
similar  diseased  tendencies.  In  the  great  majority  of 
instances  this  will  undoubtedly  be  true.  Under 
such  conditions  the  children  can  hardly  escape  inher- 
ited tendencies  to  disease  of  body,  and  probably  of 
mind  also.  Common  observation  affords  abundant 
confirmation  of  the  unhappy  results  of  such  unions. 
For  the  sake  of  posterity,  public  sentiment,  if  not 
statute  law,  should  render  marriages  of  this  kind 
impossible. 

But  some  other  marriages  are  fraught  with  almost 
as  much  of  probable  danger  to  offspring  as  those 
between  persons  near  of  kin.  Two  individuals  with 
similar  and  highly  nervous  organizations  incur  great 
risk  in  forming  the  marriage  relation  with  each  other. 

They  should  seek  as  partners  persons  of   different 
10 


146  TWENTY-FIVE   YEARS 

temperaments  and  of  strong  and  steady  nerves.  It  is 
little  short  of  positive  madness  for  those  who  have 
inherited  an  insane  tendency  to  intermarry.  Under 
such  circumstances  this  tendency  is  much  more  likely 
to  be  fully  developed  in  the  parties  themselves,  and 
it  would  be  almost  a  miracle  if  their  children  should 
escape  some  permanent  form  of  mental  unsoundness. 
Love  is  proverbially  blind  and  deaf,  and  the  teach- 
ings of  wisdom  and  experience  go  for  nothing  when 
confronted  by  passion  and  fancy  and  personal  inter- 
est; but  it  is  none  the  less  an  imperative  duty  to  use 
all  the  means  within  one's  power  to  enlighten  the 
ignorant,  to  excite  the  attention  of  the  heedless,  and 
to  warn  the  wilful  and  reckless.  Some  may  be  saved : 
some  will  be  saved ;  though  many  will  doubtless 
"pass  on  and  be  punished,"  as  the  foolish  have  been 
doing  in  all  the  ages.  It  were  better  for  themselves, 
for  their  friends,  and  for  the  world,  if  some  individ- 
uals should  remain  even  as  Paul,  unmarried,  though 
for  quite  another  reason.  Says  Dr.  Godding;  "I  do 
not  expect  to  recover  love  from  his  blindness,  but  all 
the  more  I  recognize  how  far  up  in  '  the  glorious  pro- 
cession of  saints  and  martyrs '  some  souls  will  here- 
after stand  whose  lives,  like  their  devotions,  have  been 
single,  whose  silent  purpose  has  been  that  the  inher- 
ited taint  of  their  blood  should  die  out  of  the  world 
with  them." 


WITH    THE    INSANE.  147 

Treatment  of  the  Young.  —  This  topic  necessarily 
received  some  consideration  in  a  previous  chapter, 
but  its  importance  will  justify  a  few  additional 
remarks.  Many  serious  nervous  and  mental  diseases 
have  their  origin  in  early  childhood,  or  in  that  critical 
period  when  childhood  verges  into  maturity.  In 
many  cases  children  are  permitted  practically  to  pre- 
scribe their  own  diet.  x  Subject  to  no  steady  and 
efficient  control,  gratified  in  every  caprice  for  the 
sake  of  immediate  temporary  quiet,  they  are  allowed 
to  eat  highly  seasoned  food  and  to  drink  tea  and 
coffee  and,  perhaps,  other  more  stimulating  and  ex- 
citing liquids.  In  early  youth  they  are  taken  into 
what  is  called  society,  are  cheated  of  needed  rest  and 
sleep  by  late  hours,  and  are  frequently  placed  in  cir- 
cumstances calculated  to  over-tax,  in  many  ways,  a 
delicate  and  only  partially  developed  physical  organ- 
ization. The  brain,  and  the  nervous  system  generally, 
are  especially  liable  to  receive  permanent  injury  at 
this  p'eriod.  Precocious  children  are  exposed  to 
additional  danger  from  an  unwise  and  almost  unpar- 
donable stimulating  of  their  brain  activity  by  parents 
and  teachers.  I  am  aware  that  this  is  merely  the 
repetition  of  a  tale  more  than  "twice-told."  Those 
who  have  need  to  receive  warning  will  very  likely 
read  and  smile,  if  they  read  at  all,  and  still  believe 
that  such  writing  is  mostly  "  cant."  These  are,  never- 
theless, words  of  "truth  and  soberness."  "I  speak 
that  which  I  do  know,  and  testify  to  that  which  I 


148  TWENTY-FIVE    YEAES 

have  seen."  I  recall  the  dull,  vacant  stare  of  more 
than  one  or  two  patients,  mere  boys  and  girls,  in  the 
Asylum,  whom  this  criminal  folly  had  transformed 
from  bright,  quick,  sparkling  pets  of  the  household 
into  hopeless  imbeciles.  This  is  one  of  the  sins  for 
which  there  is  little  room  for  forgiveness,  unless 
repentance  is  deep  and  bitter,  and  sought  with  many 
tears.  While  teachers  are  guilty,  the  largest  measure 
of  responsibility  and  blame  in  cases  of  this  kind  rests 
upon  parents. 

It  is  universally  agreed  by  intelligent  witnesses, 
that  the  period  of  approaching  puberty  is  a  season  of 
peculiar  exposures  and  danger  to  girls.  I  do  not 
write  as  a  physician,  but  as  a  father  of  grown-up 
daughters,  and  as  an  observer  of  many  years  in 
schools  and  elsewhere.  I  do  not  sympathize  pro- 
foundly with  the  periodic  outcries  against  school 
arrangements  and  requirements  which  are  made  re- 
sponsible for  the  largest  ghare  of  the  ills  which  afflict 
female  humanity.  Let  teachers,  and  schools,  and 
studies,  and  examinations  bear  all  the  opprobrium 
which  belongs  to  them  —  and  it  is  freely  conceded  that 
not  a  little  is  due  to  them ;  yet  the  homes  and 
mothers  and  society  must  consent,  however  unwil- 
ling, to  be  held  responsible  for  most  of  the  suffering 
entailed  upon  maturing  girlhood.  The  demands  of 
society  are  often  more  imperative  and  more  exacting 
than  those  of  the  teacher,  however  unwise  the  latter 
may  happen  to  be  in  his  requirements.  All  parties 


WITH  THE   INSANE.  149 

are  in  fault,  and  mutual  crimination  and  recrimina- 
tion will  not  "atone  for  the  past  nor  give  proper 
guaranties  for  the  future." 

If  the  evils  produced  by  bad  management  at  this 
period  were  confined  to  the  body,  there  would  be  less 
reason  for  earnestness  and  plainness  of  speech  ;  but 
many  cases  of  insanity  can  be  traced  pretty  directly 
to  unnecessary  exposure,  unreasonable  demands,  and 
improper  treatment  at  this  time.  Physicians,  well-in- 
formed mothers,  and  experienced  and  trained  nurses 
can  give  all  needed  information  in  respect  to  this  por- 
tion of  a  girl's  life.  Boys  need  oversight,  restraint, 
caution,  and  proper  instruction  at  this  period,  but 
their  exposure  to  physical  and  mental  harm  is  less 
than  that  of  the  sisters  in  the  family.  In  respect  to 
moral  danger,  the  exposure  is  probably  about  equal  to 
both  sexes. 

General  Care  of  Health.  —  It  is  not  proposed  to 
encroach,  under  this  topic,  upon  the  province  of 
the  medical  adviser,  in  any  measure.  Some  things 
belong  in  common  to  all  persons  of  ordinary  intelli- 
gence, and  especially  to  those  in  any  profession 
whose  attention  has,  by  force  of  circumstances,  been 
directed  to  them. 

I  am  persuaded  that  one  of  the  most  essential  con- 
ditions of  the  preservation  and  enjoyment  of  good 
health  is  not  to  think  too  much  and  too  constantly 
about  the  matter  of  health  and  sickness.  This  is  as 


150  TWENTY-FIVE   YEAKS 

true  of  the  mind  as  of  the  body,  and  is  of  special 
importance  in  cases  of  inherited  tendencies.  It  is  a 
very  common  saying  that  under  some  circumstances 
"we  always  find  what  we  look  for."  If  the  object  of 
our  search  does  not  exist  in  reality,  the  imagination 
will  easily  create  it,  oftentimes  in  fearfully  exagger- 
ated form.  If  one  expects  his  dinner  to  "  set  hard  " 
in  the  stomach,  and  watches  intently  for  coming  dis- 
comfort, he  will  probably  not  watch  in  vain.  Should 
something  happen  to  divert  his  attention  for  an  hour 
or  two  from  the  subject  of  food  and  digestion,  he 
may  escape  all  inconvenience  and  pain.  If  one 
expects  to  find  some  symptom  of  mental  disorder 
which  a  parent  may  possibly  have  transmitted,  and 
scrutinizes  every  thought  and  feeling,  looking  at 
everything  in  the  most  unfavorable  light,  he  will 
probably  discover  that  for  which  he  is  waiting,  at 
first  only  in  fancy,  but  soon  in  bitter  reality.  This 
process  of  introspection,  continued  day  after  day,  per- 
haps month  after  month,  finally  turns  the  action  of 
the  mind  into  the  direction  of  the  morbid  tendency. 
The  person  has  brought  upon  himself  the  very  evil 
which  he  feared ;  and  has  done  this  in  the  most  expe- 
ditious manner  and  in  accordance  with  the  well- 
known  laws  of  mental  activity.  The  inclination  to 
"  brood "  over  anticipated  feelings  is,  in  some  cases, 
the  cause  and,  in  other  cases,  the  consequence  of 
aberration  of  mind.  In  either  case  safety  demands 
that  the  inclination  shall  be  vigorously  and  persist- 


WITH   THE    INSANE.  151 

ently  resisted  by  all  the  means  in  one's  power.  The 
only  effectual  resistance  is  the  pre-occupation  of  the 
mind  by  other  subjects.  To  secure  this  is  sometimes 
extremely  difficult,  especially  if  the  current  of  mor- 
bid thought  and  feeling  has  become  thoroughly 
established.  Each  individual  case  has  its  own  pecu- 
liarities, and  no  general  rule  for  treatment  can  be 
suggested.  The  advice  of  an  intelligent  student  of 
nervous  and  mental  diseases  should  be  sought  in  all 
serious  and  doubtful  cases. 

Another  condition  of  mental  as  well  as  of  physical 
health  is  sufficient  sleep.  Sleeplessness  is  a  signal  of 
danger.  If  long-continued,  it  can  hardly  fail  to 
result  in  serious  harm.  The  nervous  force  becomes 
rapidly  exhausted;  the  power  of  self-control  is 
weakened,  and  the  mind  is  easily  unbalanced.  The 
human  system  requires  and  must  have  periods  of 
complete  repose,  and  other  seasons  when  relaxation 
can  be  secured  by  interchanging  one  mode  of  activity 
for  another.  Only  in  sleep  can  absolute  rest  be 
obtained ;  and  whoever  defrauds  nature  and  himself 
of  the  requisite  hours  of  sound  and  refreshing  sleep, 
is  sure,  in  the  end,  to  pay  a  terrible  penalty. 
Shakespeare's  lines  are  as  true  as  they  are  familiar : 

"Sleep,  that  knits  up  the  ravell'd  sleave  of  care, 
The  death  of  each  day's  life,  sore  labor's  bath, 
Balm  of  hurt  minds,  great  nature's  second  course, 
Chief  nourisher  in  life's  feast." 


152  TWENTY-FIVE   YEARS 

It  is  pretty  generally  agreed  that,  while  no  abso- 
lute rule  can  be  given,  the  average  time  required  by 
the  ordinary  adult  is  not  less  than  eight  hours  of  the 
twenty-four.  Some  persons  need  even  more,  and  a 
few  can  retain  good  health  with  less.  The  demand 
of  the  system  for  sleep  is  modified  by  age  and,  to 
some  extent,  by  employments.  It  was  formerly 
taught  that  brain-workers  could  satisfy  the  wants'  of 
nature  with  fewer  hours  of  sleep  than  men  engaged 
in  mere  manual  labor.  This  idea  has  been  aban- 
doned, and  it  is  now  universally  conceded  that 
vigorous  mental  activity  exhausts  the  vital  force  and 
the  nervous  energy  more  than  muscular  exercise,  and 
calls  fora  corresponding  increase  in  the  time  set  apart 
for  rest. 

The  quality  of  sleep  is  believed  to  be  of  as  much 
importance  as  the  quantity.  The  most  refreshing 
sleep  is  that  of  which  memory  gives  us  no  account 
when  we  are  awake, —  a  quiet,  dreamless,  uncon- 
scious state  of  complete  repose.  More,  if  possible, 
than  others,  the  student,  the  teacher,  and  brain-work- 
ers in  general,  have  need  of  this  unconscious  and 
absolute  sleep. 

The  so-called  sleep  during  which  one  continues  the 
mental  work  with  which  he  has  been  occupied 
during  the  day  and  evening,  or  with  which  he  is 
excited  and  harassed  by  continuous  and  half-waking 
dreams,  and  tormented  by  dangers  and  difficulties, 
brings  little  real  rest,  and  has  little  restorative  power. 


WITH  THE   INSANE.  153 

Such,  a  condition,  if  long  permitted,  can  not  fail  to 
produce  serious  evils.  A  person  suffering  in  this 
way  should  question  his  habits  of  life  and  his 
methods  of  work,  in  order  to  discover  and  remove 
the  causes  of  this  unnatural  state  of  body  and  mind, 
before  they  have  wrought  permanent  and  irreparable 
damage. 

So  far  as  experience  and  observation  enable  me  to 
judge,  no  general  rules  of  much  value  can  be  sug- 
gested for  "going  to  sleep."  Each  individual  will 
require  advice  suited  to  his  own  peculiarities,  and  to 
the  immediate  causes  of  his  sleeplessness,  and  to  the 
conditions  and  circumstances  by  which  he  is  sur- 
rounded. Resort  to  sleep-producing  drugs  should  be 
had  only  in  extreme  cases,  and  then  under  the  direc- 
tion of  a  wise  medical  adviser. 

Under  ordinary  circumstances  few  things  contrib- 
ute more  to  mental  health  than  cheerfulness  and 
proper  mental  activity.  A  cheerful,  hopeful  disposi- 
tion is  so  much  a  native  endowment  that  it  may  be 
doubted  whether  one  can  have  this  happy  temper 
unless  it  has  come  to  him  as  a  blessed  inheritance. 
Observation,  however,  justifies  the  conclusion  that,  by 
persistent  and  rightly  directed  effort,  a  person  may 
attain  to  a  good  degree  of  this  health-giving  and 
health-preserving  quality  of  mind. 

If  one  side  of  the  path  along  which  we  are  obliged 
to  go  day  by  day,  is  bordered  with  flowers  and  all 
beautiful  things,  and  the  other  side  with  repulsive 


154  TWENTY-FIVE   YEAKS 

and  disgusting  objects,  it  is  within  our  own  power  to 
choose  which  we  will  see.  It  is  as  easy  to  look  one 
way  as  the  other.  It  is  as  easy  to  be  charmed  and 
delighted  as  it  is  to  be  disgusted  and  pained.  Even 
if  the  classes  are  intermingled  upon  the  same  side,  it 
is  still  largely  left  for  us  to  determine  upon  which  the 
the  eye  shall  feast  itself.  Real  human  life  has  much 
the  same  possibility  of  selection;  and  the  choice 
which  one  makes  goes  to  determine  very  largely  the 
habitual  tone  and  spirit  of  his  mind.  Some  persons 
insist  on  seeing  and  remembering  only  the  disagree- 
able incidents  of  a  journey,  only  the  faults  and  foi- 
bles of  their  friends,  and  only  the  inconveniences  and 
discomforts  of  their  surroundings.  Others  have  a 
native  or  acquired  faculty  of  discovering  and  treasur- 
ing up  things  just  the  reverse  of  these.  It  is  possible 
to  cultivate  either  of  these  tendencies,  and  thus  to 
cultivate  cheerfulness  or  its  opposite. 

It  will  not  be  questioned  by  any  intelligent  thinker 
that  proper  mental  activity  must  be  a  condition  of 
mental  health  as  certainly  as  appropriate  physical 
exercise  is  a  condition  of  bodily  vigor  and  strength. 
As  surely  as  an  arm  unused  fails  to  develop  in  pro- 
portion and  harmony  with  other  properly  exercised 
members  of  the  body,  and  soon  becomes  practically 
useless,  so  surely  any  unemployed  intellectual  faculty 
becomes  dwarfed  and  powerless.  Allow  all  the 
faculties  to  lie  dormant,  or  to  be  exercised  only 
in  a  dull,  tread-mill  round  of  petty  duties,  into  which 


WITH  THE   INSANE.  155 

no  change  or  variety  ever  comes,  every  succeeding 
day  being  an  exact  reproduction  and  repetition  of 
yesterday,  and  mental  life  and  vigor  will,  in  a  major- 
ity of  cases,  gradually  become  enfeebled,  and  in  some 
cases  the  man  or  woman  will  become  a  hopeless,  and 
usually  a  harmless  imbecile.  If  to  this  mental  stag- 
nation be  added  hard,  continuous,  and  exhausting 
physical  labor,  deprivation  of  congenial  society,  and 
neglect  on  the  part  of  friends,  the  process  of  mental 
degeneration  will  be  hastened,  and  the  result  will  be 
more  profound  and  pitiable  wretchedness.  Not  a  few 
of  the  inmates  of  asylums  have  found  their  way  to 
these  institutions  along  this  cheerless  track,  in  conse- 
quence of  the  ignorance  or  insensibility  of  near  rela- 
tives and  friends.  Most  of  these  sufferers  are  women, 
many  of  them  are  wives  and  mothers.  Dr.  Stearns 
gives  an  illustrative  example  in  the  case  of  a  mother 
of  eight  children  brought  by  her  husband  to  the  asy- 
lum of  which  he  was  in  charge.  The  husband  was  at 
loss  to  conceive  any  possible  cause  for  the  insanity  of 
his  wife.  In  speaking  of  her  he  said,  "Her  is  a 
most  domestic  woman,  is  always  doing  something  for 
her  children  ;  her  is  always  at  work  for  us  all ;  never 
goes  out  of  the  house,  even  to  church  on  Sundays ; 
her  never  goes  gadding  about  at  neighbors'  houses, 
or  talking  from  one  to  another ;  her  always  had  the 
boots  blacked  in  the  morning ;  her  has  been  one  of 
the  best  wives  and  mothers,  and  was  always  at  home." 
A  more  graphic  description  of  mental  suicide,  if  the 


156  TWENTY-FIVE  YEARS 

course  of  life  was  altogether  voluntary  on  the  part  of 
the  wife,  or  of  mental  homicide,  if  the  manner  of 
living  was  compelled,  directly  or  indirectly,  by  the 
husband,  could  hardly  be  written. 

If  either  physical,  or  mental,  or  even  moral  health  is 
to  be  preserved,  something  of  variety,  of  relaxation, 
of  amusement  and  recreation,  must  be  provided  to 
break  up  the  dull  monotony  of  an  unchanging  round 
of  daily  labors,  which  come  and  go  with  the  unbroken 
regularity  of  day  and  night.  Every  impulse  of  the 
soul  cries  out  against  this  everlasting  sameness,  and 
struggles,  in  some  way,  to  be  rid  of  it  as  of  a  fright- 
ful nightmare. 

Of  the  many  other  particulars  which  might  find 
place  under  this  head,  I  will,  in  closing,  mention 
only  one :  Cultivate  a  spirit  of  faith  and  trust.  ID 
the  nature  of  things,  as  we  find  them,  "  offences  will 
come,"  occasions  of  distrust,  doubt,  perplexity. 
What  we  know  is  bounded,  on  all  sides,  by  that 
which  we  do  not  and  can  not  know  fully  and  posi- 
tively ;  we  can,  at  best,  only  believe  and  hope ;  and, 
in  some  directions,  we  find  ground  merely  for  con- 
jectures and  guesses.  It  is  not  difficult  to  keep  one's 
self  in  a  state  of  perpetual  disquiet  and  unrest  by 
grasping  after  that  which  is  quite  beyond  our  reach, 
by  striving  to  comprehend  the  incomprehensible,  to 
know  the  unknowable,  and  to  fathom  the  unfathom- 
able. Proper  mental  effort  is  not  to  be  discouraged, 
nor  is  the  disposition  to  search  and  inquire  to  be 


WITH  THE   INSANE.  157 

blamed;  but  while  all  things  may  be  lawful,  some 
things  are  inexpedient  for  individuals  of  certain 
temperaments  and  organizations.  When  the  bound- 
ary line  of  the  sure  and  certain  has  been  reached,  it 
will  be  safer  and  better  for  the  most  of  us  to  pause, 
turn  back,  and  rest  in  the  assurance  that  He,  whose 
care  extends  to  the  lilies  and  the  sparrows,  will  not 
leave  us  unprotected.  Faith  in  God  and  in  humanity, 
trust  in  Providence  and  in  friends,  will  often  save  the 
mind  from  wreck  and  the  soul  from  despair. 

"O  Lord!  how  happy  should  we  be, 
If  we  could  leave  our  cares  to  Thee, 

If  we  from  self  could  rest, 
And  feel  at  heart  that  One  above, 
In  perfect  wisdom,  perfect  love, 

Is  working  for  the  best. 
Oh !  would  these  heartless  souls  of  ours 
The  lesson  learn  from  birds  and  flowers, 

And  learn  from  self  to  cease ; 
Leave  all  things  to  our  Father's  will, 
And  in  His  mercy  trusting  still, 

Find,  in  each  trial,  peace." 


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